Individual provider Active NPI

Douglas D Lee, O.D.

  • Optometrist
  • Boulder City, NV
National Provider Identifier
1255513883
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
234 Issued in NV
Practice address
1627 Nevada Hwy
Boulder City, NV 89005-1908
Phone
(702) 294-2227
NPI assigned
Dec 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 234 NV Primary

Addresses

Primary practice location

1627 Nevada Hwy
Boulder City, NV 89005-1908

Mailing address

1627 Nevada Hwy
Boulder City, NV 89005-1908
Phone (702) 294-2227

Other identifiers 1

IdentifierTypeStateIssuer
002502008MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125001023 NV Practitioner - Optometry 0143243774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0234NVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pritchett Eye Care PC Optometrist CurrentSince Dec 1, 2016 Accepting new patients
Pritchett Eye Care PC Optometrist Current Accepting new patients
Pritchett Eye Care PC Optometrist CurrentSince Dec 1, 2016 Accepting new patients
Pritchett Eye Care PC Optometrist Past Accepting new patients
Douglas D Lee OD LTD Optometrist Past Accepting new patients

Locations

8230 W Sahara Ave
Ste 121
Las Vegas, NV 89117
Phone (702) 944-2001

10870 W Charleston Blvd
Ste 105
Las Vegas, NV 89135
Phone (702) 877-3937

1601 E Basin Ave
Ste 101
Pahrump, NV 89060
Phone (775) 751-1791

5961 S Los Altos Pkwy
Ste 101
Sparks, NV 89436
Phone (775) 359-2020

Organizations & group practices 5

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1255513883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 NEVADA HWY",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051908",
            "telephone_number": "702-294-2227",
            "fax_number": "702-293-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 NEVADA HWY",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051908",
            "telephone_number": "702-294-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DOUGLAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002502008",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder City, NV

Sources for this page

Verify at the official NPI Registry.