Individual provider Active NPI

Jenny Belken

  • Optometrist
  • Platteville, WI
National Provider Identifier
1083274492
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3565-35 Issued in WI
Practice address
1450 Eastside Rd
Platteville, WI 53818-9800
Phone
(608) 348-2331
NPI assigned
Jun 18, 2019
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3565-35 WI Primary

Addresses

Primary practice location

1450 Eastside Rd
Platteville, WI 53818-9800

Mailing address

1450 Eastside Rd
Platteville, WI 53818-9800
Phone (608) 348-2331

Other practice location 1

1400 Eastside Rd
Platteville, WI 53818-9800
Phone (608) 348-2331

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JBELKEN308674@DIRECT-EHR-SSMHC.COM Direct Southwest Health Center, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190711002309 WI Practitioner - Optometry 5597090605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Health Center IncGroup PAC ID 3072427772, 110 clinicians

Practice addresses (Care Compare)

1450 Eastside Rd
Platteville, WI 53818-9800
Phone (608) 348-4330

Merit-based Incentive Payment System (MIPS)

Final score
80.26 of 100Reported as group
Quality
92.24
Promoting interoperability
100
Improvement activities
40
Cost
41.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3565-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Health Center, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Southwest Health Center, Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

133 Performance Dr
Darlington, WI 53530
Phone (608) 776-2443

1400 Eastside Rd
Platteville, WI 53818
Phone (608) 342-4712

1450 Eastside Rd
Platteville, WI 53818
Phone (608) 348-2331

Interoperability endpoints

  • Direct secure messaging: jbelken308674@direct-ehr-ssmhc.com

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

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1083274492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-348-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-348-2331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Eastside Rd",
            "address_purpose": "LOCATION",
            "city": "Platteville",
            "state": "WI",
            "postal_code": "538189800",
            "country_code": "US",
            "telephone_number": "608-348-2331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELKEN",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3565-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JBELKEN308674@DIRECT-EHR-SSMHC.COM",
            "affiliation": "Y",
            "affiliationName": "Southwest Health Center, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "JBELKEN308674@DIRECT-EHR-SSMHC.COM",
            "address_1": "1450 Eastside Rd",
            "city": "Platteville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "538189800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Platteville, WI

Sources for this page

Verify at the official NPI Registry.