Individual provider Active NPI

Laura H Lee, O.D.

  • Optometrist
  • Federal Way, WA
National Provider Identifier
1619196128
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00002095 Issued in WA
Practice address
28815 Pacific Hwy S
Ste 2
Federal Way, WA 98003-3876
Phone
(253) 941-7074
Fax
(253) 941-5079
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00002095 WA Primary

Addresses

Primary practice location

28815 Pacific Hwy S
Ste 2
Federal Way, WA 98003-3876

Mailing address

28815 Pacific Hwy S
Suite 2
Federal Way, WA 98003
Phone (253) 941-7074

Other identifiers 2

IdentifierTypeStateIssuer
2015147MedicaidWA
0217194OtherWALABOR AND INDUSTRIES

Other names 1

  • Kyung H Lee Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080507000039 WA Practitioner - Optometry 7416035159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1992
Medicare assignment
May accept Medicare assignment
Group practices
DRS Jackson and Lee IncGroup PAC ID 4880771724, 2 clinicians

Practice addresses (Care Compare)

28815 Pacific Hwy S
Suite 2
Federal Way, WA 98003-3876
Phone (253) 941-7074

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2095WAMDChiropractor

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1619196128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28815 PACIFIC HWY S",
            "address_2": "SUITE 2",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-941-7074",
            "fax_number": "253-941-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28815 PACIFIC HWY S",
            "address_2": "STE 2",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033876",
            "telephone_number": "253-941-7074",
            "fax_number": "253-941-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LAURA",
        "middle_name": "H",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00002095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015147",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0217194",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYUNG",
            "last_name": "LEE",
            "middle_name": "H",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.