DR. IVAN JISOO LEE MD
NPI 1942769831
Ophthalmology in Fullerton, CA
About Dr. Ivan Jisoo Lee Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. IVAN JISOO LEE MD (NPI 1942769831) is an individual ophthalmology provider in Fullerton, California, licensed in California (A200827) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of Oakland Univ, William Beaumont School Of Medicine (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Ivan Jisoo Lee Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Ivan Lee reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fullerton, CA 92835
- Reassigned Medicare billing, California enrollment
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92835 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FULLERTON, CA 92835
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ivan Lee's NPI number?
The NPI number for Ivan Lee is 1942769831. It was assigned to this individual provider in the NPPES registry on March 19, 2019.
Where is Ivan Lee located?
Ivan Lee practices at 301 W Bastanchury Rd Ste 285, Fullerton, CA 92835. The listed phone number is (714) 738-4620.
What is Ivan Lee's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Ivan Lee enrolled in Medicare?
Yes. Ivan Lee is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Ivan Lee's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ivan Lee reassigns Medicare benefits to Retina Consultants Of Orange County, A Medical Corporation (Fullerton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ivan Lee's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ivan Lee accept?
Health plans from Antidote Health Plan of Ohio, Inc. list Ivan Lee as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ivan Lee was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Ivan Jisoo Lee, MD · NPI 1942769831
Ophthalmology physician in Fullerton, California. Individual provider, active in the CMS NPPES registry since March 19, 2019.
## Identity
- **NPI:** 1942769831 (Entity type: Individual)
- **Enumerated:** March 19, 2019
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** A200827 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 301 W BASTANCHURY RD STE 285, Fullerton, CA 92835-3432
- **Phone:** (714) 738-4620
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Retina Consultants Of Orange County, A Medical Corporation (NPI 1770539702, Fullerton, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Oakland Univ, William Beaumont School Of Medicine, class of 2019
## Record status
- **NPPES last updated:** December 2, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1942769831) · Data from the CMS NPPES public registry.