Individual provider Active NPI

Julie M Le, OD

  • Optometrist
  • Lowell, MA
National Provider Identifier
1306802178
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5117 Issued in MA
Practice address
161 Jackson St
Lowell, MA 01852-2103
Phone
(978) 937-9700
Fax
(978) 221-6205
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5117 MA Primary
Optometrist 152W00000X NH0717 NH

Addresses

Primary practice location

161 Jackson St
Lowell, MA 01852-2103

Mailing address

474 West Street
Keene, NH 03431
Phone (603) 352-7803

Other identifiers 1

IdentifierTypeStateIssuer
30351596MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060215000100 NH Practitioner - Optometry 8820003650 Reassigns benefits to 1 organization
I20180113000046 MA Practitioner - Optometry 8820003650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowell Community Health Center, Inc.Group PAC ID 6204807944, 85 clinicians

Practice addresses (Care Compare)

101 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0717NHMDRegistered Dietitian
NH0717NHMDOptometrist
5117MAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Dec 8, 2017 Accepting new patients
Lowell Community Health Center, Inc. CurrentSince Dec 8, 2017 Accepting new patients
Merrimack Vision Care, LLC Optometrist CurrentSince Dec 1, 2015 Accepting new patients
Robert Marc Tyszko Optometrist CurrentSince Mar 22, 2017 Accepting new patients
John F Minteer OD PLLC PastSince Mar 22, 2017 Accepting new patients

Locations

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

2075 S Willow St
Manchester, NH 03103
Phone (603) 424-0404

87 Elm St
Manchester, NH 03101
Phone (603) 935-5966

2075 S Willow St
Ste 2
Manchester, NH 03103

603 Nashua St
Ste 3
Milford, NH 03055
Phone (603) 672-0338

129 Wilton Rd
Peterborough, NH 03458
Phone (603) 924-9591

Interoperability endpoints

  • Direct secure messaging: jle18387@direct.ctc.masshiway.net

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1306802178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 WEST STREET",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-352-7803",
            "fax_number": "603-358-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JACKSON ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522103",
            "telephone_number": "978-937-9700",
            "fax_number": "978-221-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "JULIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5117",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "NH0717",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30351596",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.