Individual provider Active NPI

Jeane M Lee, OD

  • Optometrist
  • Elmont, NY
National Provider Identifier
1053557934
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0057271 Issued in NY
Practice address
733 Elmont Rd
Elmont, NY 11003-4035
Phone
(516) 341-0555
NPI assigned
Dec 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0057271 NY Primary

Addresses

Primary practice location

733 Elmont Rd
Elmont, NY 11003-4035

Mailing address

1445 Hempstead Tpke
Elmont, NY 11003-2400
Phone (516) 616-1771

Other practice location 1

1445 Hempstead Tpke
Elmont, NY 11003-2400
Phone (516) 616-1771

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230911000845 NY Practitioner - Optometry 8729442769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elmont Optometry PLLCGroup PAC ID 0446650741, 3 clinicians

Practice addresses (Care Compare)

733 Elmont Rd
Elmont, NY 11003-4035
Phone (516) 341-0555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV0057271NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elmont Optometry PLLC Optometrist CurrentSince Jun 18, 2023 Accepting new patients

Locations

733 Elmont Rd
Elmont, NY 11003
Phone (516) 341-0555

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1053557934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 HEMPSTEAD TPKE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032400",
            "telephone_number": "516-616-1771",
            "fax_number": "516-616-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034035",
            "telephone_number": "516-341-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1445 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "Elmont",
            "state": "NY",
            "postal_code": "110032400",
            "country_code": "US",
            "telephone_number": "516-616-1771",
            "fax_number": "516-616-0473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEANE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0057271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

Verify at the official NPI Registry.