Active NPI
Lee Arthur Goldstein, O.D.
- Optometrist
- Three Rivers, CA
National Provider Identifier
1952300238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4783T
- Practice address
- 45493 S Fork Dr
Three Rivers, CA 93271-9318 - Phone
- (559) 561-3204
- NPI assigned
- Jul 19, 2005
- Reactivated
- Apr 3, 2006
- Last updated
- Dec 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4783T | CA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 4783T | CA | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 4783T | CA | |
| Pediatric Optometrist | 152WP0200X | 4783T | CA |
Addresses
Primary practice location
45493 S Fork Dr
Three Rivers, CA 93271-9318
Mailing address
45493 S Fork Dr
Three Rivers, CA 93271-9318
Phone (559) 561-3204
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4783T | Other | CA | STATE BOARD - OPT LICENSE |
| 7645215 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4783T | CA | MD | Low Vision Rehabilitation Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229299200000",
"number": "1952300238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45493 S FORK DR",
"city": "THREE RIVERS",
"state": "CA",
"postal_code": "932719318",
"telephone_number": "559-561-3204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45493 S FORK DR",
"city": "THREE RIVERS",
"state": "CA",
"postal_code": "932719318",
"telephone_number": "559-561-3204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "LEE",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2008-12-15",
"deactivation_date": "2006-03-20",
"reactivation_date": "2006-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4783T",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "4783T",
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "CA",
"license": "4783T",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "CA",
"license": "4783T",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE BOARD - OPT LICENSE",
"identifier": "4783T",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7645215",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Three Rivers, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.