Active NPI
Nellie Lee
- Optometrist
- Alameda, CA
National Provider Identifier
1649319245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12200
- Practice address
- 1 Eagle Rd BLDG 1
Alameda, CA 94501-5100 - Phone
- (510) 437-3610
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- 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 | 12200 | CA | Primary |
Addresses
Primary practice location
1 Eagle Rd BLDG 1
Alameda, CA 94501-5100
Mailing address
1158 Silva LN
Alameda, CA 94502-7620
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190711001595 | CA | Order and Referring Only - Optometry | 9830424928 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12200 | CA | MD | Pediatric Occupational Therapist |
Interoperability endpoints
- nlee578467@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1649319245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1158 SILVA LN",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945027620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 EAGLE RD BLDG 1",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945015100",
"telephone_number": "510-437-3610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "NELLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.