Individual provider Active NPI

Laura Jankiprasad, O.D.

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1073048385
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5395 Issued in FL
Practice address
7077 Normandy Blvd
Jacksonville, FL 32205-6279
Phone
(904) 781-7717
NPI assigned
Apr 24, 2017
Reactivated
Aug 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5395 FL
Ophthalmology Physician 207W00000X 5395 FL
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 5395 FL Primary

Addresses

Primary practice location

7077 Normandy Blvd
Jacksonville, FL 32205-6279

Mailing address

7077 Normandy Blvd
Jacksonville, FL 32205-6279
Phone (904) 781-7717

Other practice location 1

1680 Southside Blvd Ste 100
Jacksonville, FL 32216-1924
Phone (904) 722-2020

Other practice location 2

53 Perkins Ln
Palm Coast, FL 32164-7456
Phone (386) 237-4059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20171101003326 FL Practitioner - Optometry 9830455138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Karen S Wolf OD and Gil Houston OD PAGroup PAC ID 1254392665, 3 clinicians

Practice addresses (Care Compare)

150 Professional Dr
Suite 300
Ponte Vedra Beach, FL 32082-7232
Phone (904) 285-8448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5395FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Karen S Wolf OD & Gil Houston OD PA Optometrist CurrentSince Apr 23, 2024 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients

Locations

7077 Normandy Blvd
Ste 7
Jacksonville, FL 32205
Phone (904) 781-7717

150 Professional Dr
Ste 300
Ponte Vedra Beach, FL 32082
Phone (904) 249-3937

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1073048385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7077 NORMANDY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056279",
            "telephone_number": "904-781-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7077 NORMANDY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056279",
            "telephone_number": "904-781-7717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 Southside Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322161924",
            "country_code": "US",
            "telephone_number": "904-722-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 Perkins Ln",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321647456",
            "country_code": "US",
            "telephone_number": "386-237-4059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANKIPRASAD",
        "first_name": "LAURA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2019-08-21",
        "deactivation_date": "2019-08-02",
        "reactivation_date": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5395",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "5395",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.