Active NPI
Douglas Moon Lee, O.D.
- Optometrist
- Edison, NJ
National Provider Identifier
1588677157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- NJ5303
- Practice address
- 1734 State Route 27
Edison, NJ 08817-3449 - Phone
- (732) 393-1210
- Fax
- (732) 393-1140
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NJ5303 | NJ | Primary |
Addresses
Primary practice location
1734 State Route 27
Edison, NJ 08817-3449
Mailing address
1734 State Route 27
Edison, NJ 08817-3449
Phone (732) 393-1210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050802000373 | NJ | Practitioner - Optometry | 5294763116 | Practice locations: Edison, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1994
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1734 Lincoln Hwy
Edison, NJ 08817-3449
Phone (732) 393-1210
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NJ5303 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588677157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1734 STATE ROUTE 27",
"city": "EDISON",
"state": "NJ",
"postal_code": "088173449",
"telephone_number": "732-393-1210",
"fax_number": "732-393-1140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1734 STATE ROUTE 27",
"city": "EDISON",
"state": "NJ",
"postal_code": "088173449",
"telephone_number": "732-393-1210",
"fax_number": "732-393-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DOUGLAS",
"middle_name": "MOON",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "NJ5303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.