Individual provider Active NPI

Eileen S Lee, O.D.

  • Optometrist
  • Oakland, CA
National Provider Identifier
1851355309
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8533T Issued in CA
Practice address
388 9TH St Ste 157
Oakland, CA 94607-4290
Phone
(510) 268-9600
Fax
(510) 268-1608
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8533T CA Primary

Addresses

Primary practice location

388 9TH St Ste 157
Oakland, CA 94607-4290

Mailing address

515 Creedon Cir
Alameda, CA 94502-7795
Phone (510) 839-0938

Other identifiers 1

IdentifierTypeStateIssuer
0504000002OtherCAMEDICARE NSC

Other names 1

  • Dr. Eileen S Lo Other name

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
I20111221000803 CA Practitioner - Optometry 7315035318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay Vision Center Optometry IncGroup PAC ID 5890744544, 3 clinicians

Practice addresses (Care Compare)

388 9TH St
Suite 157
Oakland, CA 94607-4290
Phone (510) 268-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RL Optometry Inc Optometrist Current Accepting new patients
East Bay Vision Center Optometry Inc Optometrist CurrentSince May 31, 1990 Accepting new patients
East Bay Vision Center Optometry Inc Optometrist Current Accepting new patients
East Bay Vision Center Optometry Inc Optometrist CurrentSince May 31, 1990 Accepting new patients

Locations

34420 Fremont Blvd
Ste E
Fremont, CA 94555
Phone (510) 796-9600

388 9th St
Ste 157
Oakland, CA 94607
Phone (510) 268-9600

1230 Harrison St
Oakland, CA 94612
Phone (510) 839-0938

670 McCormick St
San Leandro, CA 94577

Organizations & group practices 4

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1851355309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CREEDON CIR",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945027795",
            "telephone_number": "510-839-0938",
            "fax_number": "510-839-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 9TH ST STE 157",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074290",
            "telephone_number": "510-268-9600",
            "fax_number": "510-268-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EILEEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8533T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "0504000002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "LO",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.