NPIMap

Individual provider Active NPI

Stephanie Kim Lesage, OD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1568803419
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8268-T Issued in TX
Practice address
6336 Gaston Ave
Dallas, TX 75214
Phone
(713) 732-6385
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1658-692T LA
Optometrist 152W00000X 5043 MA
Optometrist 152W00000X 8268-T TX Primary

Addresses

Primary practice location

6336 Gaston Ave
Dallas, TX 75214

Mailing address

6336 Gaston Ave
Dallas, TX 75214-3926

Other practice location 1

4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone (214) 742-8387

Other identifiers 2

IdentifierTypeStateIssuer
01102701MedicaidLA
2342797MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513002608 TX Practitioner - Optometry 5890929814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

1800 N Britain Rd
Parkland Health
Irving, TX 75061-2630
Phone (214) 266-3000

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

6336 Gaston Ave
Dallas, TX 75214-3926
Phone (469) 225-9959

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1658-692TLAMDOptometrist
5043MAMDOptometrist
8268-TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Optometrist CurrentSince Aug 1, 2025 Accepting new patients
Dallas County Hospital District Current Accepting new patients
Modern Spectacle Eyecare PLLC Optometrist CurrentSince Mar 27, 2024 Accepting new patients
Dallas County Hospital District CurrentSince Aug 1, 2025 Accepting new patients

Locations

6336 Gaston Ave
Dallas, TX 75214
Phone (214) 824-7000

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: slesage504565@direct.phhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1568803419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6336 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75214",
            "telephone_number": "713-732-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 S Lancaster Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752167167",
            "country_code": "US",
            "telephone_number": "214-742-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESAGE",
        "first_name": "STEPHANIE",
        "middle_name": "KIM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1658-692T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5043",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8268-T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01102701",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2342797",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.