Active NPI
Edna Fay Lee, O.D.
- Optometrist
- San Francisco, CA
National Provider Identifier
1124191002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9032T
- Practice address
- 1907 Fillmore St
San Francisco, CA 94115-2706 - Phone
- (415) 563-9003
- Fax
- (415) 563-9006
- NPI assigned
- Nov 16, 2006
- 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 | 9032T | CA | Primary |
Addresses
Primary practice location
1907 Fillmore St
San Francisco, CA 94115-2706
Mailing address
1907 Fillmore St
San Francisco, CA 94115-2706
Phone (415) 563-9003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140527000101 | CA | Practitioner - Optometry | 2264655992 | Practice locations: San Francisco, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9032T | CA | MD | Optometrist |
| 9032 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379376000000",
"number": "1124191002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 FILLMORE ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152706",
"telephone_number": "415-563-9003",
"fax_number": "415-563-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 FILLMORE ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152706",
"telephone_number": "415-563-9003",
"fax_number": "415-563-9006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "EDNA",
"middle_name": "FAY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2013-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9032T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.