Active NPI
Heidi Lynn Schefferly, O.D.
- Optometrist
- Jackson, MI
National Provider Identifier
1063403632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003898
- Practice address
- 306 W Washington Ave
Suite 104
Jackson, MI 49201-2169 - Phone
- (517) 783-6928
- NPI assigned
- Nov 2, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003898 | MI | Primary |
Addresses
Primary practice location
306 W Washington Ave
Suite 104
Jackson, MI 49201-2169
Mailing address
4877 W Territorial Rd
Rives Junction, MI 49277-9639
Phone (517) 589-5062
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410045602 | Other | MI | PALMETTO GBA RR MEDICARE |
| BCBS OF MICHIGAN | Other | MI | 900C865230 |
| 1312340001 | Other | MI | DMERC |
| VCM-0149 | Other | MI | M-CARE |
| 22-20000 | Other | MI | PHP OF SOUTHERN MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
350 N Wisner St
Jackson, MI 49202-4225
Phone (517) 783-6928
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 125 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heidi Schefferly OD PLLC | Optometrist | Current | Accepting new patients |
| James P. Serino, O.D. P.C. | Optometrist | Past | Accepting new patients |
Locations
350 N Wisner St
Jackson, MI 49202
Phone (517) 783-6928
306 W Washington Ave
Ste 104
Jackson, MI 49201
Phone (517) 783-6928
Interoperability endpoints
- hschefferly546923@direct.hfhs.org
Organizations & group practices 2
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.
-
- Optometrist
- Jackson, MI
- NPI 1942466081
-
- Optometrist
- Jackson, MI
- NPI 1730300377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387238400000",
"number": "1063403632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4877 W TERRITORIAL RD",
"city": "RIVES JUNCTION",
"state": "MI",
"postal_code": "492779639",
"telephone_number": "517-589-5062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 W WASHINGTON AVE",
"address_2": "SUITE 104",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012169",
"telephone_number": "517-783-6928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHEFFERLY",
"first_name": "HEIDI",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-02",
"last_updated": "2013-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA RR MEDICARE",
"identifier": "410045602",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "900C865230",
"identifier": "BCBS OF MICHIGAN",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "1312340001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M-CARE",
"identifier": "VCM-0149",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP OF SOUTHERN MICHIGAN",
"identifier": "22-20000",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.