Individual provider Active NPI

Michael Guyton Lessly, O.D.

  • Optometrist
  • Jupiter, FL
National Provider Identifier
1790709699
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3355 Issued in FL
Practice address
103 S US Highway 1
B-2
Jupiter, FL 33477-5132
Phone
(561) 685-8177
Fax
(561) 746-3268
NPI assigned
Jul 26, 2006
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3355 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OPC 3355 FL
Corneal and Contact Management Optometrist 152WC0802X 0618001596 VA
Low Vision Rehabilitation Optometrist 152WL0500X OPC 3355 FL
Low Vision Rehabilitation Optometrist 152WL0500X 0618001596 VA
Pediatric Optometrist 152WP0200X OPC 3355 FL
Pediatric Optometrist 152WP0200X 0618001596 VA
Vision Therapy Optometrist 152WV0400X 0618001596 VA
Vision Therapy Optometrist 152WV0400X OPC 3355 FL

Addresses

Primary practice location

103 S US Highway 1
B-2
Jupiter, FL 33477-5132

Mailing address

103 S US Highway 1
B-2
Jupiter, FL 33477-5132
Phone (561) 685-8177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101208000276 FL Practitioner - Optometry 0941202592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 S US Hwy 1 B2
Jupiter, FL 33477-5101
Phone (561) 746-5910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2034COMDClinical Social Worker
OPC 3355FLMDVision Therapy Optometrist
0618001596VAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Lessly OD PA Optometrist CurrentSince Oct 28, 2010 Accepting new patients
Inlet Optical Boutique Inc Optometrist PastSince Oct 28, 2010 Accepting new patients

Locations

103 S US Highway 1
Ste B2
Jupiter, FL 33477
Phone (561) 685-8177

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1790709699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S US HIGHWAY 1",
            "address_2": "B-2",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775132",
            "telephone_number": "561-685-8177",
            "fax_number": "561-746-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S US HIGHWAY 1",
            "address_2": "B-2",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775132",
            "telephone_number": "561-685-8177",
            "fax_number": "561-746-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSLY",
        "first_name": "MICHAEL",
        "middle_name": "GUYTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3355",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC 3355",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "0618001596",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC 3355",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "VA",
            "license": "0618001596",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "OPC 3355",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "VA",
            "license": "0618001596",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "VA",
            "license": "0618001596",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "FL",
            "license": "OPC 3355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.