Active NPI
Chang Soo Daniel Lee, O.D.
- Optometrist
- Seabrook, NH
National Provider Identifier
1285745604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0728
- Practice address
- 700 Lafayette Rd
Unit 1
Seabrook, NH 03874-6202 - Phone
- (603) 474-1681
- Fax
- (603) 474-0695
- NPI assigned
- Aug 31, 2006
- Last updated
- Jan 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0728 | NH | Primary |
| Optometrist | 152W00000X | 4207 | MA |
Addresses
Primary practice location
700 Lafayette Rd
Unit 1
Seabrook, NH 03874-6202
Mailing address
700 Lafayette Rd
Seabrook, NH 03874-6202
Phone (603) 474-1681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4207 | MA | MD | Psychologist |
| 0728 | NH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Focus Eye Care LLC | Optometrist | Current | Accepting new patients |
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Locations
6930 W 105th St
Overland Park, KS 66212
Phone (913) 544-1115
Organizations & group practices 3
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.
-
- Optometrist
- Overland Park, KS
- NPI 1154923159
-
dba Walmart Vision Center 30-1762
- Eyewear Supplier
- Seabrook, NH
- NPI 1568543239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451865600000",
"number": "1285745604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 LAFAYETTE RD",
"city": "SEABROOK",
"state": "NH",
"postal_code": "038746202",
"telephone_number": "603-474-1681",
"fax_number": "603-474-0695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LAFAYETTE RD",
"address_2": "UNIT 1",
"city": "SEABROOK",
"state": "NH",
"postal_code": "038746202",
"telephone_number": "603-474-1681",
"fax_number": "603-474-0695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CHANG SOO",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2016-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NH",
"license": "0728",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4207",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seabrook, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.