Alexandria Nicole Jernberg, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4561 Issued in OR

Practice address

360 S Garden Way Ste 250
Eugene, OR 97401-8175

Phone

(541) 343-5000

NPI assigned

Feb 28, 2021

Sex

Female

Sole proprietor

No

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 OR

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

Pacific University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Clear Vision Institute PCGroup PAC ID 9931192515, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.49 of 100Reported as group

Quality

90.85

Improvement activities

40

Cost

80.51

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• Direct secure messaging: ajernbergod@pcvi.direct.eyemdemr.com

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.

• Pacific Clear Vision Institute, PC

  • Ophthalmology Physician
  • Eugene, OR
  • NPI 1699812719

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1614470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1013501220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 250",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018175",
            "telephone_number": "541-343-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 250",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018175",
            "telephone_number": "541-343-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Darlene Ln",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974011601",
            "country_code": "US",
            "telephone_number": "541-343-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERNBERG",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-28",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Jensen
• Shawna M. Jensen, PA
• Darrel Joe Jenson, DMD
• Alison Paige Jeppsen
• Kimberly Klose Jeremiah, MS, LPC
• Emily Paxton Jernigan
• Samantha Renee Jernstrom
• Ami Jerome-Sletteland
• Tulaasi Jerome, LMT
• Jessica Crowder LLC

• Optometrist in Eugene, OR
• Providers in Eugene, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.