Individual provider Active NPI

Jessica Christine Lee

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • San Antonio, TX
National Provider Identifier
1083176598
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
U2550 Issued in TX
Practice address
1314 E Sonterra Blvd Ste 5104
San Antonio, TX 78258-4289
Phone
(210) 495-2367
Fax
(210) 499-0470
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0200X U2550 TX Primary

Addresses

Primary practice location

1314 E Sonterra Blvd Ste 5104
San Antonio, TX 78258-4289

Mailing address

7600 Broadway Apt 3048
San Antonio, TX 78209-1979
Phone (601) 316-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624001358 TX Practitioner - Ophthalmology 8628511250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Facial and Oculoplastic Surgery Center of Texas PLLCGroup PAC ID 8527198415, 5 clinicians

Practice addresses (Care Compare)

1314 E Sonterra Blvd
Suite 5104
San Antonio, TX 78258-4289
Phone (210) 495-2367

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Facial & Oculoplastic Surgery Center of Texas, PLLC Multi-Specialty CurrentSince Jul 1, 2024 Accepting new patients

Locations

1314 E Sonterra Blvd
Ste 5104
San Antonio, TX 78258
Phone (210) 495-2367

Interoperability endpoints

  • Direct secure messaging: jlee49500@direct.phhs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1083176598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 BROADWAY APT 3048",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091979",
            "telephone_number": "601-316-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 5104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584289",
            "telephone_number": "210-495-2367",
            "fax_number": "210-499-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "U2550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.