Active NPI
Yi San Lee, OD
- Optometrist
- Flushing, NY
National Provider Identifier
1073878328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV007839-1
- Practice address
- 13620 38TH Ave Ste 7G
Flushing, NY 11354-4232 - Phone
- (718) 395-8080
- NPI assigned
- Jul 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV007839-1 | NY | Primary |
Addresses
Primary practice location
13620 38TH Ave Ste 7G
Flushing, NY 11354-4232
Mailing address
13620 38TH Ave Ste 7G
Flushing, NY 11354-4232
Phone (718) 395-8080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV007839-1 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1073878328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13620 38TH AVE STE 7G",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113544232",
"telephone_number": "718-395-8080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13620 38TH AVE STE 7G",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113544232",
"telephone_number": "718-395-8080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "YI SAN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV007839-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.