Individual provider Active NPI

Jennifer Le

  • Optometrist
  • Dorchester, MA
National Provider Identifier
1538599014
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5004 Issued in MA
Practice address
636 Columbia Rd
Dorchester, MA 02125-3416
Phone
(617) 825-9839
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTG00603 RI
Optometrist 152W00000X 5004 MA Primary

Addresses

Primary practice location

636 Columbia Rd
Dorchester, MA 02125-3416

Mailing address

636 Columbia Rd
Dorchester, MA 02125-3416
Phone (617) 825-9839

Other practice location 1

30 Leeward Rd
Fall River, MA 02720-7914
Phone (508) 642-4215

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jele@uphams.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140224000788 MA Practitioner - Optometry 7517197353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 Columbia Rd
Dorchester, MA 02125-2424
Phone (617) 287-8000

500 Columbia Rd
Dorchester, MA 02125-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5004MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Upham'S Corner Health Committee, Inc. CurrentSince Jun 23, 2020 Accepting new patients

Locations

636 Columbia Rd
Dorchester, MA 02125
Phone (617) 825-9839

415 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

500 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

Interoperability endpoints

  • Direct secure messaging: jle310596@direct.ochin.org

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": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1538599014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253416",
            "telephone_number": "617-825-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253416",
            "telephone_number": "617-825-9839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Leeward Rd",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027207914",
            "country_code": "US",
            "telephone_number": "508-642-4215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00603",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jele@uphams.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "636 Columbia Rd",
            "city": "Dorchester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021253416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.