Individual provider Active NPI

Judy Y. M. Lee, O.D.

  • Optometrist
  • Bellerose, NY
National Provider Identifier
1902938368
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005665 Issued in NY
Practice address
25121 Jamaica # 2027
Bellerose, NY 11426-2218
Phone
(718) 807-3515
Fax
(516) 488-2003
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV005665 NY Primary

Addresses

Primary practice location

25121 Jamaica # 2027
Bellerose, NY 11426-2218

Mailing address

200 Sunrise Mall
Vision Center
Massapequa, NY 11758-4340
Phone (516) 799-5261

Other practice location 1

200 Sunrise Mall
Massapequa, NY 11758-4340
Phone (516) 799-5261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200410001053 NY Practitioner - Optometry 9133558265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV005665NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center, Inc CurrentSince Dec 31, 2023 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Dec 31, 2023 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 2

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1902938368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SUNRISE MALL",
            "address_2": "VISION CENTER",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584340",
            "telephone_number": "516-799-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25121 JAMAICA # 2027",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262218",
            "telephone_number": "718-807-3515",
            "fax_number": "516-488-2003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Sunrise Mall",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117584340",
            "country_code": "US",
            "telephone_number": "516-799-5261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUDY",
        "middle_name": "Y. M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellerose, NY

Sources for this page

Verify at the official NPI Registry.