Individual provider Active NPI

Susan Stowers Lee, O.D.

  • Optometrist
  • Greensboro, GA
National Provider Identifier
1801956503
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
GA1465 Issued in GA
Practice address
1051 A Park Dr.
Greensboro, GA 30642-3465
Phone
(706) 453-4535
Fax
(706) 453-4539
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X GA1465 GA Primary

Addresses

Primary practice location

1051 A Park Dr.
Greensboro, GA 30642-3465

Mailing address

1051 A Park Dr.
Greensboro, GA 30642-3465
Phone (706) 453-4535

Other identifiers 2

IdentifierTypeStateIssuer
000672581LMedicaidGA
410045041OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20111003000054 GA Practitioner - Optometry 3870604002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perry K Lee OD PCGroup PAC ID 8224149455, 4 clinicians

Practice addresses (Care Compare)

6061 Lake Oconee Pkwy
Greensboro, GA 30642-3798
Phone (706) 453-4535

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.86
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001465GAMDMarriage & Family Therapist
GA1465GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Perry K Lee OD PC Optometrist CurrentSince May 15, 2000 Accepting new patients

Locations

1051 Park Dr
#A
Greensboro, GA 30642
Phone (706) 453-4535

6061 Lake Oconee Pkwy
Greensboro, GA 30642
Phone (706) 453-4535

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1801956503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 A PARK DR.",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306423465",
            "telephone_number": "706-453-4535",
            "fax_number": "706-453-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 A PARK DR.",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306423465",
            "telephone_number": "706-453-4535",
            "fax_number": "706-453-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "middle_name": "STOWERS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA1465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000672581L",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410045041",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, GA

Sources for this page

Verify at the official NPI Registry.