Individual provider Active NPI

John Young Lee, O.D.

  • Optometrist
  • Westwood, NJ
National Provider Identifier
1962694356
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00613900 Issued in NJ
Practice address
219 Old Hook Rd
Westwood, NJ 07675-3131
Phone
(201) 664-0847
Fax
(201) 664-0847
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007224-1 NY
Optometrist 152W00000X 27OA00613900 NJ Primary

Addresses

Primary practice location

219 Old Hook Rd
Westwood, NJ 07675-3131

Mailing address

219 Old Hook Rd
Westwood, NJ 07675-3131
Phone (201) 664-0847

Other identifiers 1

IdentifierTypeStateIssuer
0181234MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090825000056 NJ Practitioner - Optometry 3173606431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

219 Old Hook Rd
Westwood, NJ 07675-3131
Phone (201) 664-0847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007224-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
J Lee Optometry LLC Optometrist CurrentSince Aug 26, 2009 Accepting new patients

Locations

219 Old Hook Rd
Westwood, NJ 07675
Phone (201) 664-0847

Organizations & group practices 1

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1962694356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753131",
            "telephone_number": "201-664-0847",
            "fax_number": "201-664-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753131",
            "telephone_number": "201-664-0847",
            "fax_number": "201-664-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007224-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00613900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181234",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

Verify at the official NPI Registry.