Individual provider Active NPI

Matthew Brian Lee, O.D

  • Optometrist
  • Merced, CA
National Provider Identifier
1194706952
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12952 Issued in CA
Practice address
708 W 20TH St
Suite 8
Merced, CA 95340-3639
Phone
(209) 384-2335
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12952 CA Primary

Addresses

Primary practice location

708 W 20TH St
Suite 8
Merced, CA 95340-3639

Mailing address

2869 Saint Thomas CT
Merced, CA 95348-3370
Phone (209) 388-1837

Other practice location 1

5192 Hospital Road
Mariposa, CA 95338-9533
Phone (209) 966-0780

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120127000294 CA Practitioner - Optometry 0244407500

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

708 W 20TH St
Suite a
Merced, CA 95340-3639
Phone (209) 384-2335

841 E Alexander Ave
Merced, CA 95340-3639

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12952CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Matthew B. Lee, O.D. Inc Optometrist CurrentSince Dec 21, 2019 Accepting new patients
Jeffrey B. Lee O.D. Optometrist PastSince Nov 21, 2011 Accepting new patients

Locations

708 W 20th St
Ste 8
Merced, CA 95340
Phone (209) 384-2335

708 W 20th St
Ste A
Merced, CA 95340
Phone (209) 384-2335

Organizations & group practices 2

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1194706952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2869 SAINT THOMAS CT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483370",
            "telephone_number": "209-388-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W 20TH ST",
            "address_2": "SUITE 8",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953403639",
            "telephone_number": "209-384-2335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5192 Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Mariposa",
            "state": "CA",
            "postal_code": "953389533",
            "country_code": "US",
            "telephone_number": "209-966-0780",
            "fax_number": "209-398-8758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MATTHEW",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.