Active NPI
Jessica Kao Lee, O.D.
- Optometrist
- Vancouver, WA
National Provider Identifier
1053627398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD60839586
- Practice address
- 2525 NE 139TH St Ste 280
Vancouver, WA 98686-2719 - Phone
- (360) 882-2778
- NPI assigned
- Aug 24, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14060 | CA | |
| Optometrist | 152W00000X | OD60839586 | WA | Primary |
Addresses
Primary practice location
2525 NE 139TH St Ste 280
Vancouver, WA 98686-2719
Mailing address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone (360) 882-2778
Other names 1
- Jessica Kao
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14060 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myoptic Optometry, LLC | Current | Accepting new patients |
Locations
3978 N Williams Ave
Portland, OR 97227
Phone (503) 493-7070
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 and National Provider Directory roles.
-
- Point of Service
- Portland, OR
- NPI 1235325333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1053627398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986644896",
"telephone_number": "360-882-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 NE 139TH ST STE 280",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986862719",
"telephone_number": "360-882-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JESSICA",
"middle_name": "KAO",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-24",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14060",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD60839586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "KAO",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.