Jaclyn Elizabeth Doffin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2988 Issued in MN

Practice address

4750 Washington SQ
White Bear Lake, MN 55110-3257

Phone

(651) 429-3379

Fax

(651) 429-8681

NPI assigned

May 9, 2006

Last updated

May 21, 2008By the provider in NPPES

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MN

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

Indiana University - School of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doffin Family Eye Care PAGroup PAC ID 6608142898, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doffin Family Eye Care PA

  dba White Bear Eye Clinic and Optical

  • Optometrist
  • White Bear Lake, MN
  • NPI 1346291630
  Medicare reassignment Care Compare group
• JJS Optical LLC

  dba Metro Optics

  • Optometrist
  • Saint Paul, MN
  • NPI 1316010218
  NPD (past)
• JJS Optical LLC

  dba Dinkytown Optical

  • Optometrist
  • Minneapolis, MN
  • NPI 1780823070
  NPD (past)
• Minnesota Eye Consultants, PA

  • Ophthalmology Physician
  • Bloomington, MN
  • NPI 1508839879
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1053360701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 WASHINGTON SQ",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103257",
            "telephone_number": "651-429-3379",
            "fax_number": "651-429-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WASHINGTON SQ",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103257",
            "telephone_number": "651-429-3379",
            "fax_number": "651-429-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOFFIN",
        "first_name": "JACLYN",
        "middle_name": "ELIZABETH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "132424",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2202621",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "869675600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1011968",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "612R1ST",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP46401",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Dimitri, ST
• Delores A Dinzeo, LP
• Jordan Dittberner, DDS
• Hedda Stellyn Dodds
• Doffin Family Eye Care PA (White Bear Eye Clinic and Optical)
• Sharon Kay Doffing, MSLP
• Jenica E Domanico, MA, OTR/L
• Angie Donnay
• Patrick Thomas Dornack, M.D.
• Betsy Lynn Doucette

• Optometrist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.