Individual provider Active NPI

Adam James Lee, O.D.

  • Optometrist
  • Avondale, AZ
National Provider Identifier
1790934842
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1638 Issued in AZ
Practice address
10750 W McDowell Rd
Ste. A100
Avondale, AZ 85392-5960
Phone
(623) 877-3007
Fax
(623) 877-4488
NPI assigned
Sep 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1638 AZ Primary

Addresses

Primary practice location

10750 W McDowell Rd
Ste. A100
Avondale, AZ 85392-5960

Mailing address

10750 W McDowell Rd
Ste. A100
Avondale, AZ 85392-5960
Phone (623) 877-3007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090616000250 AZ Practitioner - Optometry 9931259835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adam J Lee PCGroup PAC ID 6709009731, 3 clinicians

Practice addresses (Care Compare)

10750 W McDowell Rd
Suite A100
Avondale, AZ 85392-5961
Phone (623) 877-3007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1638AZMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam J. Lee, PC Optometrist CurrentSince Feb 1, 2014 Accepting new patients

Locations

10750 W McDowell Rd
Ste A100
Avondale, AZ 85392
Phone (623) 877-3007

4236 N Verrado Way
Ste 103
Buckeye, AZ 85396
Phone (623) 792-1955

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1790934842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD",
            "address_2": "STE. A100",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925960",
            "telephone_number": "623-877-3007",
            "fax_number": "623-877-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD",
            "address_2": "STE. A100",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925960",
            "telephone_number": "623-877-3007",
            "fax_number": "623-877-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ADAM",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-13",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.