Lee Raymond Light, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0020345 Issued in FL

Practice address

10971 Bonita Beach Rd
Ste 1
Bonita Springs, FL 34135-9033

Phone

(239) 262-1833

Fax

(239) 262-3097

NPI assigned

Jun 29, 2006

Last updated

Jan 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dr. Lee R. Light M.D.

  • Specialist
  • Naples, FL
  • NPI 1932214848
  NPD Authorized official
• Lee Raymond Light MD PA

  • Internal Medicine Physician
  • Bonita Springs, FL
  • NPI 1861657736
  Authorized official Same address or phone
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1285662395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10971 BONITA BEACH RD",
            "address_2": "STE 1",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341359033",
            "telephone_number": "239-262-1833",
            "fax_number": "239-262-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10971 BONITA BEACH RD",
            "address_2": "STE 1",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341359033",
            "telephone_number": "239-262-1833",
            "fax_number": "239-262-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "LEE",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0020345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUE SHIELD",
            "identifier": "71218",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.

Verify at the official NPI Registry.