Davisson W Li, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00712800 Issued in NJ

Practice address

160 Passaic Ave Ste 1
Kearny, NJ 07032-1130

Phone

(201) 467-2004

NPI assigned

Jun 21, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• National Vision, Inc

  • Optician
  • Kearny, NJ
  • NPI 1770096844
  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1457082356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PASSAIC AVE APT 125-103",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070321137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PASSAIC AVE STE 1",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070321130",
            "telephone_number": "201-467-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "DAVISSON",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00712800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yillian Leal, DMD
• Lisa Marie Leonard, LPN
• Lauren Marie Leone
• Edward Stuart Levey, DMD
• Robert S Levy, DMD
• Liberty Eye Care II
• Little a'S Therapy
• Joseph Augustine Loboda Jr., D.M.D
• Stephanie Giselle Lopez, LCSW
• Luxottica Retail North America Inc

• All providers in Kearny, NJ
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.