Derek Jeanes

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002719 Issued in AZ

Practice address

3192 Willow Creek Rd
Prescott, AZ 86301-6610

Phone

(928) 445-1234

Fax

(602) 508-4830

NPI assigned

May 3, 2023

Sex

Male

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 AZ

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Doctors of Arizona PLLCGroup PAC ID 3870835044, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.66 of 100Reported as group

Quality

84.9

Promoting interoperability

100

Improvement activities

40

Cost

77.31

Merit-based Incentive Payment System (MIPS)

Final score

57.93 of 100Reported as group

Quality

70.27

Promoting interoperability

0

Improvement activities

40

Cost

72.83

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.jeanes.p20@direct.avp.nextgenshare.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.

• Eye Doctors of Arizona PLLC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1982268298
  Medicare reassignment Care Compare group NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1376574707
  Medicare reassignment NPD
• Southwestern Eye Center LTD

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1023063187
  Medicare reassignment NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1043910078
  NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ophthalmology Physician
  • Safford, AZ
  • NPI 1649202771
  NPD
• Southwestern Eye Center, LTD

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1558102608

  Optometrist

  NPD
• Warren H Heller MD

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1720457013
  NPD (past)

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1043909229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 S ROCKFORD DR STE 220",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852886226",
            "telephone_number": "928-445-1324",
            "fax_number": "602-508-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3192 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "928-445-1234",
            "fax_number": "602-508-4830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3223 N Windsong Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863141222",
            "country_code": "US",
            "telephone_number": "928-775-6121",
            "fax_number": "602-508-4830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "399 W Palomino Rd",
            "address_purpose": "LOCATION",
            "city": "Chino Valley",
            "state": "AZ",
            "postal_code": "863235648",
            "country_code": "US",
            "telephone_number": "928-636-5504",
            "fax_number": "928-636-7080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEANES",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Jaramillo
• Olamide D Jarrett, M.D.
• Jamie Jarvis, PA-C
• Jason C. Campbell DDS.
• Francisco Jaume, D.O.
• Jeff Henderson PHD Psychological Services and Consulting PC
• Renee A Jelinek, M.D.
• Jacqueline Jendrisak
• Roger Cain Jenkins Jr., MD
• Karen E Jensen, LCSW, CCM

• Optometrist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.