Organization Active NPI

John J Lee OD PC

  • Optometrist
  • Hanover, MA
National Provider Identifier
1033412374
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4502 Issued in MA
Legal business name
JOHN J LEE OD PC
Practice address
1422 Washington St
Hanover, MA 02339-1694
Phone
(781) 826-8393
Fax
(781) 826-8764
NPI assigned
Dec 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
John J Lee, ODNPI 1134115116
Title
Owner
Phone
(781) 585-1668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4502 MA Primary

Addresses

Primary practice location

1422 Washington St
Hanover, MA 02339-1694

Mailing address

1422 Washington St
Hanover, MA 02339-1694
Phone (781) 826-8393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110418000407 MA Part B Supplier - Clinic/Group Practice 5294919122 Receives reassigned benefits from 1 practitioner
Practice locations: Hanover, MA; Kingston, MA

National Provider Directory

National Provider Directory

Locations

101 Kingston Collection Way
Ste C102
Kingston, MA 02364
Phone (781) 585-1668

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1033412374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 WASHINGTON ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391694",
            "telephone_number": "781-826-8393",
            "fax_number": "781-826-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 WASHINGTON ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391694",
            "telephone_number": "781-826-8393",
            "fax_number": "781-826-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J LEE OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-585-1668",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.