Individual provider Active NPI

Rachel Lee, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1619379278
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14986 Issued in CA
Practice address
3068 University Ave
San Diego, CA 92104-3034
Phone
(619) 298-5524
Fax
(619) 298-5524
NPI assigned
Sep 25, 2014
Last updated
May 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 814 NV
Optometrist 152W00000X 14986 CA Primary

Addresses

Primary practice location

3068 University Ave
San Diego, CA 92104-3034

Mailing address

3068 University Ave
San Diego, CA 92104-3034
Phone (619) 298-5524

Other practice location 1

8321 La Mesa Blvd
LA Mesa, CA 91942-0217
Phone (619) 550-0403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170217001722 CA Practitioner - Optometry 3375826373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meredith Walton OD Optometric CorporationGroup PAC ID 4183997513, 5 clinicians

Practice addresses (Care Compare)

3068 University Ave
San Diego, CA 92104-3034
Phone (619) 298-5524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
814NVMDGeneral Practice Dentistry
14986CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith Walton OD, Optometric Corporation Optometrist CurrentSince Sep 27, 2023 Accepting new patients
Heights Optometry Optometrist PastSince Sep 27, 2023 Accepting new patients

Locations

8321 La Mesa Blvd
La Mesa, CA 91942
Phone (619) 550-0403

3068 University Ave
San Diego, CA 92104
Phone (619) 298-5524

3404 Adams Ave
San Diego, CA 92116
Phone (619) 431-5393

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1619379278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3068 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043034",
            "telephone_number": "619-298-5524",
            "fax_number": "619-298-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3068 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043034",
            "telephone_number": "619-298-5524",
            "fax_number": "619-298-5524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8321 La Mesa Blvd",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919420217",
            "country_code": "US",
            "telephone_number": "619-550-0403",
            "fax_number": "619-550-0403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "814",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.