Individual provider Active NPI

Fred Kieun Lee, O.D.

  • Optometrist
  • Norman, OK
National Provider Identifier
1396901187
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2567 Issued in OK
Practice address
15951 Little Axe Dr
Norman, OK 73026-9088
Phone
(405) 447-0300
Fax
(405) 701-7914
NPI assigned
Aug 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2567 OK Primary

Addresses

Primary practice location

15951 Little Axe Dr
Norman, OK 73026-9088

Mailing address

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200130000916 TX Practitioner - Optometry 7517016272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizen Potawatomi NationGroup PAC ID 3375511488, 35 clinicians

Practice addresses (Care Compare)

781 Grand Casino Blvd
Shawnee, OK 74804-1005
Phone (405) 964-4025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation CurrentSince Dec 20, 2022 Accepting new patients
Citizen Potawatomi Nation CurrentSince Dec 20, 2022 Accepting new patients

Locations

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

Organizations & group practices 2

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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1396901187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "FRED",
        "middle_name": "KIEUN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.