NPIMap

Individual provider Active NPI

Phison Le, O.D.

  • Optometrist
  • Boston, MA
National Provider Identifier
1194074385
Registry record updated Sep 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4939 Issued in MA
Practice address
150 S Huntington Ave
Boston, MA 02130-4817
Phone
(617) 232-9500
NPI assigned
Sep 3, 2012
Last updated
Sep 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4939 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Boston, MA 02130-4817

Mailing address

150 S Huntington Ave
Boston, MA 02130-4817
Phone (617) 232-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170908000191 MA Practitioner - Optometry 8224258017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothouse Health Inc.Group PAC ID 8729991021, 51 clinicians

Practice addresses (Care Compare)

1353 Dorchester Ave
Dorchester, MA 02122-2932
Phone (617) 288-3230

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dothouse Health Inc. CurrentSince Jun 18, 2017 Accepting new patients

Locations

1353 Dorchester Ave
Dorchester, MA 02122
Phone (617) 288-3230

Interoperability endpoints

  • Direct secure messaging: ple181620@direct.bmc.masshiway.net

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1346630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346630400000",
    "number": "1194074385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "PHISON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-03",
        "last_updated": "2012-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.