Jaclyn Marie McKenzie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004609 Issued in MI

Practice address

3601 Washtenaw Ave
Ann Arbor, MI 48104-5277

Phone

(734) 973-1712

Fax

(734) 973-1712

NPI assigned

Dec 13, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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

Specialty

Optometry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Insight Eye Care Professionals PCGroup PAC ID 6800155094, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Insight Eye Care Professionals, P.C.

  • Optometrist
  • Sioux Falls, SD
  • NPI 1780100941
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1013210160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5048 PINEWOOD DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481165132",
            "telephone_number": "810-923-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 WASHTENAW AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045277",
            "telephone_number": "734-973-1712",
            "fax_number": "734-973-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul E McKeever, MD
• Barbara J McKenna, MD
• Erin McKenna, LLMSW
• Katrina Zacharczuk McKenna, CRNA
• Kate McKenney
• Brian J McKeon, PA
• Dana Renee McKeon, MD
• Vince McKeon
• Tiffany McKinney-Roy, LLMSW
• Lecreshia McKinney-Stege, PHD

• Optometrist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.