Converge Neuro Optometry LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CONVERGE NEURO OPTOMETRY LLC

Practice address

9975 SW Frewing St Ste 130
Tigard, OR 97223-5091

Phone

(503) 906-3596

Fax

(503) 906-1014

NPI assigned

Nov 18, 2025

Organization subpart

No

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

Authorized official

Name

Macson Lee, O.D.NPI 1740251529

Title

Ceo, OD, Fovdra

Phone

(650) 521-4570

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Macson Yen Lee, O.D.

  • Optometrist
  • Tigard, OR
  • NPI 1740251529
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1427919729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13010 SW CASPIAN CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087760",
            "telephone_number": "650-521-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 SW FREWING ST STE 130",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235091",
            "telephone_number": "503-906-3596",
            "fax_number": "503-906-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVERGE NEURO OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MACSON",
        "authorized_official_title_or_position": "CEO, OD, FOVDRA",
        "authorized_official_telephone_number": "650-521-4570",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isobel Conner, MS, QMHP, LPCI
• Matthew W Conrad
• Mimosa Constans, MA, LPC
• Alhaji Joseph Conteh I
• Maria Celeste Contreras
• Joshua Paul Cook
• Kelly Cook
• Mary Kathleen Cook, QMHA-R, CRM
• Quirena Ann Natividad Cook
• Rebecca Cook

• Optometrist in Tigard, OR
• Providers in Tigard, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.