Individual provider Active NPI

Jennifer Maize Lesslie, O.D.

  • Optometrist
  • North Charleston, SC
National Provider Identifier
1518052083
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1131 Issued in SC
Practice address
1370 Remount Road
Suite B
North Charleston, SC 29406
Phone
(843) 747-7663
Fax
(843) 747-7665
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1131 SC Primary

Addresses

Primary practice location

1370 Remount Road
Suite B
North Charleston, SC 29406

Mailing address

824 High Battery Cir
Mt Pleasant, SC 29464-7881
Phone (843) 881-1292

Other identifiers 1

IdentifierTypeStateIssuer
D11315MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20141008001096 SC Practitioner - Optometry 1850506601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lessco, Inc.Group PAC ID 9537128913, 2 clinicians

Practice addresses (Care Compare)

1370 Remount Rd
Suite B
N Charleston, SC 29406-3322
Phone (843) 747-7663

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lessco, Inc. Optometrist CurrentSince Jan 1, 2002 Accepting new patients

Locations

1370 Remount Rd
Ste B
North Charleston, SC 29406
Phone (843) 747-7663

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1518052083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 HIGH BATTERY CIR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647881",
            "telephone_number": "843-881-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 REMOUNT ROAD",
            "address_2": "SUITE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-747-7663",
            "fax_number": "843-747-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSLIE",
        "first_name": "JENNIFER",
        "middle_name": "MAIZE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D11315",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.