Individual provider Active NPI

Stella Lou Lee, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1336115658
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
006242 Issued in NY
Practice address
17 Elizabeth St
Suite 401
New York, NY 10013-4803
Phone
(212) 226-3937
Fax
(212) 226-3372
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 006242 NY Primary

Addresses

Primary practice location

17 Elizabeth St
Suite 401
New York, NY 10013-4803

Mailing address

17 Elizabeth St
Suite 401
New York, NY 10013-4803
Phone (212) 226-3937

Other identifiers 4

IdentifierTypeStateIssuer
C389E1OtherNYBLUE CROSS BLUE SHIELD
6501889OtherNYGHI
P2576713OtherNYOXFORD
02239632MedicaidNY

Other names 1

  • Stella Lou Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000273 NY Practitioner - Optometry 7618921446 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Eye Physician PLLCGroup PAC ID 4981658853, 5 clinicians

Practice addresses (Care Compare)

99 Elizabeth St
2ND FL
New York, NY 10013-4729
Phone (212) 227-8837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eye Physician PLLC Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Grand Fashion Optical, Inc Optometrist CurrentSince Jan 1, 2023 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

2 Mott St
Rm 206
New York, NY 10013
Phone (212) 227-4505

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336115658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST",
            "address_2": "SUITE 401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134803",
            "telephone_number": "212-226-3937",
            "fax_number": "212-226-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST",
            "address_2": "SUITE 401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134803",
            "telephone_number": "212-226-3937",
            "fax_number": "212-226-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOU LEE",
        "first_name": "STELLA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "C389E1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6501889",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2576713",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02239632",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STELLA",
            "last_name": "LOU",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.