Active NPI
Lee-Jiuan Luque, O.D.
- Optometrist
- Lancaster, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11937TLG
- Practice address
- 44665 Valley Central Way
Lancaster, CA 93536-6500 - Phone
- (661) 942-7007
- Fax
- (866) 926-9833
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11937TLG | CA | Primary |
Addresses
Primary practice location
44665 Valley Central Way
Lancaster, CA 93536-6500
Mailing address
29023 Mirada Circulo
Valencia, CA 91354-1591
Phone (949) 726-2842
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0119370 | Medicaid | CA |
Other names 1
- Lee-Jiuan Ong
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
43112 15TH St W
Lancaster, CA 93534-6219
Phone (661) 726-2378
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11937TLG | CA | MD | Optometrist |
| 11937 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
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 and National Provider Directory roles.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Panorama City, CA
- NPI 1407888928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1316917339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29023 MIRADA CIRCULO",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913541591",
"telephone_number": "949-726-2842",
"fax_number": "866-926-9833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44665 VALLEY CENTRAL WAY",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935366500",
"telephone_number": "661-942-7007",
"fax_number": "866-926-9833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUQUE",
"first_name": "LEE-JIUAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11937TLG",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0119370",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "c-cda",
"address_1": "43112 N 15th St",
"city": "LANCASTER",
"state": "CA",
"country_code": "US",
"postal_code": "935346219",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LEE-JIUAN",
"last_name": "ONG",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.