NPIMap

Organization Active NPI

East Bay Ophthalmology

  • Ophthalmology Physician
  • Pinole, CA
National Provider Identifier
1871783308
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A87505 Issued in CA
Legal business name
EAST BAY OPHTHALMOLOGY
Practice address
1289 Pinole Valley Rd
Pinole, CA 94564-1348
Phone
(510) 724-1768
Fax
(888) 959-0487
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Dr. Scott E Lee, M.D.NPI 1699720946
Title
Physician/Ophthalmologist
Phone
(510) 724-1768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A87505 CA Primary

Addresses

Primary practice location

1289 Pinole Valley Rd
Pinole, CA 94564-1348

Mailing address

1700 San Pablo Avenue
Suite a
Pinole, CA 94564
Phone (510) 724-1768

Other names 1

  • SCOTT E. LEE, M.D. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071120000720 CA Part B Supplier - Clinic/Group Practice 3274621578 Receives reassigned benefits from 7 practitioners
Practice locations: Pinole, CA

National Provider Directory

National Provider Directory

Locations

1320 Tara Hills Dr
Ste C
Pinole, CA 94564
Phone (510) 724-1768

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1871783308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SAN PABLO AVENUE",
            "address_2": "SUITE A",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-724-1768",
            "fax_number": "888-959-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 PINOLE VALLEY RD",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641348",
            "telephone_number": "510-724-1768",
            "fax_number": "888-959-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY OPHTHALMOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "510-724-1768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A87505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCOTT E. LEE, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "SCOTT E. LEE, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pinole, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.