Individual provider Active NPI

Jennifer Lee, O.D.

  • Optometrist
  • Long Beach, CA
National Provider Identifier
1891147351
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33443 Issued in CA
Practice address
2925 Palo Verde Ave
Long Beach, CA 90815-1552
Phone
(562) 799-2020
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33443 CA Primary

Addresses

Primary practice location

2925 Palo Verde Ave
Long Beach, CA 90815-1552

Mailing address

2925 Palo Verde Ave
Long Beach, CA 90815-1552
Phone (562) 799-2020

Other practice location 1

3816 Woodruff Ave Ste 100
Long Beach, CA 90808-2145
Phone (800) 898-2020

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
I20170106001832 CA Practitioner - Optometry 2264713106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
JC Edwards School of Medicine, Marshall University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hertzog Eye Associates a Medical CorporationGroup PAC ID 0547238792, 3 clinicians

Practice addresses (Care Compare)

5094 E Los Coyotes Diagonal
Long Beach, CA 90815-2839
Phone (562) 597-3100

Merit-based Incentive Payment System (MIPS)

Final score
92.88 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33443CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hertzog Eye Associates a Medical Corporation CurrentSince Mar 1, 2024 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Lenscrafters Optometrist Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

5094 E Los Coyotes Diagonal
Long Beach, CA 90815
Phone (562) 595-4366

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1891147351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151552",
            "telephone_number": "562-799-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151552",
            "telephone_number": "562-799-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3816 Woodruff Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908082145",
            "country_code": "US",
            "telephone_number": "800-898-2020",
            "fax_number": "844-897-3788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIFER",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.