Robert Fredrick Lee III, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003122 Issued in MI

Practice address

15157 Gratiot Ave
Detroit, MI 48205-1324

Phone

(313) 526-7664

Fax

(313) 526-2055

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SVS Vision Inc

  • Optometrist
  • Mount Clemens, MI
  • NPI 1194879023
  Medicare reassignment NPD
• Dr Robert F Lee

  • Optometrist
  • Detroit, MI
  • NPI 1346402856
  NPD (past) Authorized official
• SVS Vision Inc

  • Optometrist
  • Mount Pleasant, MI
  • NPI 1558246942
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1013909555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15157 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051324",
            "telephone_number": "313-526-7664",
            "fax_number": "313-526-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15157 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051324",
            "telephone_number": "313-526-7664",
            "fax_number": "313-526-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROBERT",
        "middle_name": "FREDRICK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3289816",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Shean-Young Lee
• Pauline Dominique C Lee, CRNA
• Rachel S Lee, MD
• Renee Lee, RN
• Richard Lee, DO
• Rose Lee, BCBA
• Sabrina Lee, MD
• Samuel Lee, M.D.
• Sarah Jai-Eun Lee, M.D.
• Sol Hee Lee, M. D.

• Optometrist in Detroit, MI
• Providers in Detroit, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.