Individual provider Active NPI

Jalene Haynes, O.D.

  • Optometrist
  • Daytona Beach, FL
National Provider Identifier
1013322627
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4949 Issued in FL
Practice address
1900 Mason Ave
Suite 100
Daytona Beach, FL 32117-5116
Phone
(386) 274-5525
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4949 FL Primary

Addresses

Primary practice location

1900 Mason Ave
Suite 100
Daytona Beach, FL 32117-5116

Mailing address

1900 Mason Ave
Suite 100
Daytona Beach, FL 32117-5116
Phone (386) 274-5525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140813001898 FL Practitioner - Optometry 2769609833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision One IncGroup PAC ID 9830197623, 8 clinicians

Practice addresses (Care Compare)

1900 Mason Ave
Suite 100
Daytona Beach, FL 32117-5116
Phone (386) 274-5525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision One Inc Optometrist CurrentSince Jul 23, 2014 Accepting new patients
Vision One Inc Optometrist PastSince Jul 23, 2014 Accepting new patients
Vision One Inc Optometrist PastSince Jul 23, 2014 Accepting new patients

Locations

1900 Mason Ave
Ste 100
Daytona Beach, FL 32117
Phone (386) 274-5525

801 N Stone St
Deland, FL 32720
Phone (386) 734-4431

3820 S Nova Rd
Port Orange, FL 32127
Phone (386) 767-0068

Networks

  • FL HMO D-SNP
  • FL HMO
  • FL PPO
  • Freedom Health HMO Network
  • FL HMO C-SNP

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1013322627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MASON AVE",
            "address_2": "SUITE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175116",
            "telephone_number": "386-274-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MASON AVE",
            "address_2": "SUITE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175116",
            "telephone_number": "386-274-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "JALENE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.