MONICA E LEE M.D.
NPI 1215129309
Internal Medicine - Hematology & Oncology in Fullerton, CA

NPI Status: Active since August 14, 2007

Contact Information

2151 N HARBOR BLVD STE 3200
FULLERTON, CA
ZIP 92835
Phone: (714) 446-5900

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 20
Internal Medicine
Hematology & Oncology
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About MONICA LEE

This page provides the complete NPI Profile along with additional information for Monica Lee, an internist established in Fullerton, California with a medical specialization in Internal Medicine, focusing in hematology & oncology and more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1215129309 assigned on August 2007. The practitioner's primary taxonomy code is 207RH0003X with license number A101114 (CA). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI: 1215129309
Provider Name: MONICA E LEE M.D.
Gender: Female
Entity Type: Individual
Location Address: 2151 N HARBOR BLVD STE 3200 FULLERTON, CA 92835
Location Phone: (714) 446-5900
Mailing Address: 2151 N HARBOR BLVD STE 3200 FULLERTON, CA 92835
Mailing Phone: (714) 446-5900
Medical School Name: OTHER
Graduation Year: 2006
Is Sole Proprietor?: No
Enumeration Date: 08-14-2007
Last Update Date: 10-04-2022
Code Navigator

An internist like Monica Lee is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Hematology & Oncology
Taxonomy Code: 207RH0003X
Type: Allopathic & Osteopathic Physicians
License No.: A101114
License State: CA
Taxonomy Description: An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine	A101114 (CA)

Medicare Participation & PECOS Enrollment Status

Monica Lee is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Monica Lee is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 9931353844
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20130130000340
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 30-39 minutes
Insertion of needle into vein for collection of blood sample
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $46.9 for a new patient copayment and $27.49 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 92835 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

Average New Patient Price $187.6
Minimum New Patient Price $62.96
Maximum New Patient Price $187.6

Average New Patient Copayment $46.9
Minimum New Patient Copayment $15.74
Maximum New Patient Copayment $46.9

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $109.96
Minimum Established Patient Price $20.84
Maximum Established Patient Price $153.61

Average Established Patient Copayment $27.49
Minimum Established Patient Copayment $5.21
Maximum Established Patient Copayment $38.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
e-Prescribing	96%	1048
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Medication Reconciliation	85%	176
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	37%	789
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	63%	789
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215129309, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 18 → 1 + 8

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 2 + 2 + 1 + 8 + 3 + 0 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9

This NPI is valid

The calculated check digit is 9, which matches the last digit of 1215129309.