Kenny Benjamin Lee, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

2878AT Issued in OR

Practice address

1865 NW 169TH PL
Suite 105
Beaverton, OR 97006-7327

Phone

(503) 533-8441

Fax

(503) 533-8403

NPI assigned

Jun 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunset Eye Clinic LLCGroup PAC ID 3678624301, 6 clinicians

Sunset Vision Center LLCGroup PAC ID 9830242924, 5 clinicians

Practice addresses (Care Compare)

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.

• Sunset Eye Clinic LLC

  • Optometrist
  • Beaverton, OR
  • NPI 1174549364
  Medicare reassignment Care Compare group NPD Authorized official
• Sunset Vision Center LLC

  • Optometrist
  • Hillsboro, OR
  • NPI 1104997659
  Medicare reassignment Care Compare group NPD Authorized official
• Sunset Vision Center

  • Optometrist
  • Cornelius, OR
  • NPI 1811918949
  NPD (past) Authorized official

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619905866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17184 SW ARTESIAN DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064990",
            "telephone_number": "503-533-8441",
            "fax_number": "503-533-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 NW 169TH PL",
            "address_2": "SUITE 105",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067327",
            "telephone_number": "503-533-8441",
            "fax_number": "503-533-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2878AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181436",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Lee, PHARM.D
• Ji Hyun Lee, O.D.
• Jonathan Chunhan Lee, D.D.S.
• Julie Lee, L.AC.MACOM
• Karie Lee, DMD
• Kwang Hee Lee
• Micah Lee, LMT
• Michael JS Lee
• Priscilla Lee, DPT
• Seung Won Lee, DC

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

• 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.

Verify at the official NPI Registry.