Susannah Lee, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3632AT Issued in OR

Practice address

339 NW 9TH Ave
Portland, OR 97209

Phone

(503) 219-0023

Fax

(503) 219-0024

NPI assigned

Jul 31, 2015

Last updated

Mar 12, 2019By the provider in NPPES

Sex

Female

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

Enrolled in OR2 enrollments

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 2

Specialty

Optometry

Education

California University of Science and Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Susannah Lee Eye Care

  • Optometrist
  • Hillsboro, OR
  • NPI 1093215949
  Medicare reassignment NPD Authorized official
• The Eye Studio, PC

  • Optometrist
  • Portland, OR
  • NPI 1235458274
  Medicare reassignment NPD
• Fred Meyer Stores Inc

  dba Fred Meyer Pharmacy

  • Community/Retail Pharmacy
  • Hillsboro, OR
  • NPI 1700821196
  NPD (past)
• National Vision, Inc.

  • Eyewear Supplier
  • Hillsboro, OR
  • NPI 1285671321
  NPD (past)
• Fred Meyer Stores Inc.

  dba QFC Pharmacy #835

  • Community/Retail Pharmacy
  • Lynnwood, WA
  • NPI 1558235762
  NPD (past)

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1558747576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 NW 9TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093306",
            "telephone_number": "503-219-0023",
            "fax_number": "503-219-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 NW 9TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "503-219-0023",
            "fax_number": "503-219-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSANNAH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3632AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Christine Lee, DO
• Shelby Lynn Lee
• Shelly Lee, PHARMD
• Sophia Irene Lee, MD
• Suk Ki Kathleen Lee, D.D.S.
• Tailer Lee
• Takayla Lee
• Tamsin Lee, LAC
• Taylor A Lee
• Thai-Hien DO Lee, MSN, FNP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.