Active NPI
Nanna Ka-Man Lee, O.D.
- Optometrist
- Bridgewater, NJ
National Provider Identifier
1336379809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00670000
- Practice address
- 400 Commons Way Ste 327
Bridgewater, NJ 08807-2822 - Phone
- (908) 704-8855
- NPI assigned
- Jul 19, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV007441 | NY | |
| Optometrist | 152W00000X | 27OA00670000 | NJ | Primary |
Addresses
Primary practice location
400 Commons Way Ste 327
Bridgewater, NJ 08807-2822
Mailing address
400 Commons Way
Box 327 #3310
Bridgewater, NJ 08807
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3811803 | Other | NY | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV007441 | NY | MD | Optometrist |
| 007441 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1336379809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 COMMONS WAY",
"address_2": "BOX 327 #3310",
"city": "BRIDGEWATER",
"state": "NJ",
"postal_code": "08807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 COMMONS WAY STE 327",
"city": "BRIDGEWATER",
"state": "NJ",
"postal_code": "088072822",
"telephone_number": "908-704-8855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "NANNA",
"middle_name": "KA-MAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-19",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV007441",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00670000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "3811803",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgewater, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.