Individual provider Active NPI

Kenneth Shao-Sung Lee, O.D.

  • Optometrist
  • Honolulu, HI
National Provider Identifier
1548365653
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD-331 Issued in HI
Practice address
888 S King St
Honolulu, HI 96813-3009
Phone
(808) 522-4430
Fax
(808) 522-4431
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD-331 HI Primary

Addresses

Primary practice location

888 S King St
Honolulu, HI 96813-3009

Mailing address

888 S King St
Straub Department of Ophthalmology
Honolulu, HI 96813-3009
Phone (808) 522-4430

Other identifiers 2

IdentifierTypeStateIssuer
07108101MedicaidHI
00A0092401OtherHIHMSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20110118000472 HI Practitioner - Optometry 9537358841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD-331HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Nov 11, 2010 Accepting new patients
Straub Clinic & Hospital CurrentSince Nov 11, 2010 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

1946 Young St
Ste 320
Honolulu, HI 96826

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1548365653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "address_2": "STRAUB DEPARTMENT OF OPHTHALMOLOGY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133009",
            "telephone_number": "808-522-4430",
            "fax_number": "808-522-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133009",
            "telephone_number": "808-522-4430",
            "fax_number": "808-522-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNETH",
        "middle_name": "SHAO-SUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07108101",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00A0092401",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.