Individual provider Active NPI

Patrick Shuenchung Lee, O.D.

  • Optometrist
  • Fountain Valley, CA
National Provider Identifier
1942465968
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13528 Issued in CA
Practice address
18045 Magnolia St
Fountain Valley, CA 92708-5638
Phone
(714) 593-3937
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13528 CA Primary

Addresses

Primary practice location

18045 Magnolia St
Fountain Valley, CA 92708-5638

Mailing address

18045 Magnolia St
Fountain Valley, CA 92708-5638
Phone (714) 593-3937

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
I20091201000510 CA Practitioner - Optometry 6800935008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18045 Magnolia St
Fountain Valley, CA 92708-5638
Phone (714) 593-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13528CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spex 88 Optometry Corp Optometrist CurrentSince Sep 15, 2010 Accepting new patients
Golden San Gabriel Optometric Vision Center Optometrist PastSince Oct 1, 2001 Accepting new patients
Total Vision PC Optometrist PastSince Nov 1, 2021 Accepting new patients

Locations

18045 Magnolia St
Fountain Valley, CA 92708
Phone (714) 593-3937

Organizations & group practices 3

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1942465968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18045 MAGNOLIA ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085638",
            "telephone_number": "714-593-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18045 MAGNOLIA ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085638",
            "telephone_number": "714-593-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PATRICK",
        "middle_name": "SHUENCHUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.