Lee James Carter, O.D.
Individual provider Active NPI Optometrist · Mountain Home, ID
NPI 1891789368 · NPPES record last updated Feb 4, 2013
Key facts
- NPI
- 1891789368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- ODP-100084 (ID)
- Practice address
- 2745 American Legion Blvd
Mountain Home, ID 83647-3185 - Phone
- (208) 587-0974
- Fax
- (208) 587-0994
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emmett Eye Center, PLLC
Practice addresses (Care Compare)
1108 S Washington Ave
Emmett, ID 83617-3535
Phone (208) 365-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051206000318 | ID | Practitioner - Optometry | 6608896980 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP-100084 | ID | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emmett Eye Center, PLLC | Optometrist | Current |
Accepting new patients |
| Idaho Eyelid & Facial Plastic Surgery , PLLC | Optometrist | Past |
Accepting new patients |
| Sparhawk Vision, CHTD | Past | Accepting new patients | |
| Southern Idaho Vision Alliance,PLLC | Optometrist | Past | Accepting new patients |
Locations
1108 S Washington Ave
Emmett, ID 83617
Phone (208) 365-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP-100084 | ID | Yes |
Addresses
Primary practice location
2745 American Legion Blvd
Mountain Home, ID 83647-3185
Mailing address
2745 American Legion Blvd
Mountain Home, ID 83647-3185
Phone (208) 587-0974
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807254900 | Medicaid | ID |
Other providers in Mountain Home, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.