Organization Active NPI

Leevision Ophthalmology Services PLLC

  • Ophthalmology Physician
  • Flushing, NY
National Provider Identifier
1760633788
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
205979 Issued in NY
Legal business name
LEEVISION OPHTHALMOLOGY SERVICES PLLC
Practice address
142-18 38TH Ave.
Suite #1a
Flushing, NY 11354
Phone
(718) 461-5050
Fax
(718) 461-5656
NPI assigned
Oct 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Authorized official

Name
David H. LeeNPI 1003848714
Title
President
Phone
(718) 461-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 205979 NY Primary

Addresses

Primary practice location

142-18 38TH Ave.
Suite #1a
Flushing, NY 11354

Mailing address

142-18 38TH Ave.
Suite #1a
Flushing, NY 11354
Phone (718) 461-5050

Other identifiers 2

IdentifierTypeStateIssuer
01740789MedicaidNY
94T632OtherNYEMPIRE MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041104000437 NY Part B Supplier - Clinic/Group Practice 9032172754 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

14218 38th Ave
Ste Cfa
Flushing, NY 11354
Phone (718) 461-5050

Interoperability endpoints

  • Direct secure messaging: dlee@lvos.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1760633788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142-18 38TH AVE.",
            "address_2": "SUITE #1A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-461-5050",
            "fax_number": "718-461-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142-18 38TH AVE.",
            "address_2": "SUITE #1A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-461-5050",
            "fax_number": "718-461-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEEVISION OPHTHALMOLOGY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-461-5050"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "205979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01740789",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE MEDICARE",
            "identifier": "94T632",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.