Jaquelyn Pena, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

11109 Issued in TX

Practice address

2188 State Highway 46 W Ste 102
New Braunfels, TX 78132-4467

Phone

(830) 302-3357

Fax

(830) 302-3358

NPI assigned

Apr 25, 2023

Last updated

Jun 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jackie Vega Former name

Medicare fee-for-service enrollment

Enrolled in TX

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacob Family Eye Care PLLC

  • Optometrist
  • Lockhart, TX
  • NPI 1467780312
  Medicare reassignment NPD
• Kyle Vision PLLC

  • Optometrist
  • Kyle, TX
  • NPI 1538403688
  Medicare reassignment NPD
• Bandera Eye Care PLLC

  • Optician
  • Bandera, TX
  • NPI 1366168445

  Optometrist

  NPD (past)
• Vision Plus LLC

  • Optician
  • San Antonio, TX
  • NPI 1124493762

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1063100311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2188 STATE HIGHWAY 46 W STE 102",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781324467",
            "telephone_number": "830-302-3357",
            "fax_number": "830-302-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2188 STATE HIGHWAY 46 W STE 102",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781324467",
            "telephone_number": "830-302-3357",
            "fax_number": "830-302-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JAQUELYN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "VEGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ramona K Peck, M.D.
• Anne Michelle Pedersen, P.T.
• Deanna Peirsol
• Gregory Pelton, CSFA
• Cindy Pena, LPC
• Neena M. Penagaluru, M.D.
• Steven J Pennock, RPH
• Pep Talk Pediatrics
• Alexandra Perez, LPC
• Andrea Perez

• Optometrist in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.