Individual provider Active NPI

Brandon G Lesueur, O.D.

  • Optometrist
  • Lincoln, CA
National Provider Identifier
1831281880
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10061 Issued in CA
Practice address
845 Twelve Bridges Dr
Ste 130
Lincoln, CA 95648-8819
Phone
(916) 231-0034
Fax
(916) 231-0038
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10061 CA Primary

Addresses

Primary practice location

845 Twelve Bridges Dr
Ste 130
Lincoln, CA 95648-8819

Mailing address

845 Twelve Bridges Dr
Suite 130
Lincoln, CA 95648-8819
Phone (916) 645-3937

Other identifiers 1

IdentifierTypeStateIssuer
10061OtherCALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110517000689 CA Practitioner - Optometry 5193901643 Practice locations: Lincoln, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

845 Twelve Bridges Dr
Lincoln, CA 95648-8819
Phone (916) 645-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10061CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Eye Consultants a Med Corp Optometrist Past Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1831281880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 TWELVE BRIDGES DR",
            "address_2": "SUITE 130",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488819",
            "telephone_number": "916-645-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 TWELVE BRIDGES DR",
            "address_2": "STE 130",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488819",
            "telephone_number": "916-231-0034",
            "fax_number": "916-231-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESUEUR",
        "first_name": "BRANDON",
        "middle_name": "G",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "10061",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, CA

Sources for this page

Verify at the official NPI Registry.