LEE SA B. JACKSON M.D. NPI 1306837042

NPI Information

  • NPI: 1306837042
  • Provider Name: LEE SA B. JACKSON, M.D.
  • Classification: Ophthalmology - 207W00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4824 E BASELINE RD
    SUITE 110
    MESA, AZ
    ZIP 85206
  • Phone: (480) 615-2020

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NPI Details

Lee Sa B. Jackson, M.D. is an ophthalmology in Mesa, AZ with 33 years of experience. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. Lee Sa B. Jackson, M.D. NPI is 1306837042. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:1992

The provider's business location address is:

4824 E BASELINE RD
SUITE 110
MESA, AZ
ZIP 85206-676
Phone: (480) 615-2020
Fax: (480) 219-9957

The NPI 1306837042 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient complete exam of visual system (HCPCS:92014)
  • Photography of the retina (HCPCS:92250)
  • Exam of visual field with extended testing (HCPCS:92083)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Measurement of corneal curvature and depth of eye (HCPCS:92136)
  • Closure of tear duct opening using plug (HCPCS:68761)
  • Laser repair to improve eye fluid flow (HCPCS:65855)
  • New patient complete exam of visual system (HCPCS:92004)
  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Removal of recurring cataract in lens capsule using a laser (HCPCS:66821)
  • Established patient problem focused exam of visual system (HCPCS:92012)
  • Cataract surgery (HCPCS:NAN11)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 11/2/2005 and was last updated on 11/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmology25793ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1404731MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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