Individual provider Active NPI

John J Lee, MD

  • Ophthalmology Physician
  • Havertown, PA
National Provider Identifier
1811973472
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD071940L Issued in PA
Practice address
2050 W Chester Pike
Suite 100
Havertown, PA 19083-2742
Phone
(610) 789-6701
Fax
(610) 789-6704
NPI assigned
Dec 15, 2005
Last updated
Mar 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD071940L PA Primary

Addresses

Primary practice location

2050 W Chester Pike
Suite 100
Havertown, PA 19083-2742

Mailing address

2050 W Chester Pike
Suite 100
Havertown, PA 19083-2742
Phone (610) 789-6701

Other identifiers 1

IdentifierTypeStateIssuer
053512T23OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411000615 PA Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 4880591437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD071940LPAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edmonds & Associates LLC Past Accepting new patients
Annesley Flanagan Fischer Stefanyszyn and Associates Ophthalmology PastSince Aug 2, 2020 Accepting new patients
Pennsylvania Retina Specialists PC Ophthalmology Past Accepting new patients
Ophthalmic Partners of Pennsylvania, PC Ophthalmology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDBFBA

Organizations & group practices 5

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1811973472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 W CHESTER PIKE",
            "address_2": "SUITE 100",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832742",
            "telephone_number": "610-789-6701",
            "fax_number": "610-789-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 W CHESTER PIKE",
            "address_2": "SUITE 100",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832742",
            "telephone_number": "610-789-6701",
            "fax_number": "610-789-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD071940L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "053512T23",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

Verify at the official NPI Registry.