John M Lennon Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2448 Issued in FL

Practice address

2504 Crill Ave
Palatka, FL 32177-4264

Phone

(386) 328-5141

Fax

(386) 328-5141

NPI assigned

Nov 30, 2005

Sex

Male

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 2

Other names 1

• Dr. John M Lennon Jr. Professional name

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Duval Eye Associates PLLCGroup PAC ID 4688082969, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Duval Eye Associates PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1982298865
  Medicare reassignment Care Compare group NPD
• St Johns Eye Care P a

  • Optometrist
  • Palatka, FL
  • NPI 1912053547
  Medicare reassignment NPD Authorized official
• Patrick L Reardon OD

  • Optometrist
  • Jacksonville, FL
  • NPI 1588054324
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1104800697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774264",
            "telephone_number": "386-328-5141",
            "fax_number": "386-328-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774264",
            "telephone_number": "386-328-5141",
            "fax_number": "386-328-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNON",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078883000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20313",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "LENNON",
            "middle_name": "M",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jameshia S Lee
• Yeongsoon K Lee, PHARMD
• Legacy Dream House Inc
• Legacy Home Health Care Inc
• Louis Legum, PHD.
• Vincent Michael Leth Jr., D.M.D.
• Angelina Heiser Lewis, ARNP
• Channon Brown Lewis, DC
• Katherine M. Lewis
• Leslie Ann Lewis, LMT

• Optometrist in Palatka, FL
• Providers in Palatka, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.