Individual provider Active NPI

Jean-Guy Bilodeau

  • Optometrist
  • Apache Junction, AZ
National Provider Identifier
1124642871
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002595 Issued in AZ
Practice address
183 W Apache TRL Ste 101
Apache Junction, AZ 85120-3426
Phone
(480) 824-7360
NPI assigned
May 28, 2020
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002595 AZ Primary
Optometrist 152W00000X 5801 FL

Addresses

Primary practice location

183 W Apache TRL Ste 101
Apache Junction, AZ 85120-3426

Mailing address

4084 E Catclaw St
Gilbert, AZ 85296-9542
Phone (954) 614-2092

Other practice location 1

2610 SE Federal Hwy
Stuart, FL 34994-4535
Phone (772) 403-0175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002595AZMDOptometrist
5801FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Inc Optometrist CurrentSince Aug 27, 2023 Accepting new patients

Locations

183 W Apache Trl
Ste 101
Apache Junction, AZ 85120
Phone (480) 824-7360

Organizations & group practices 1

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1124642871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4084 E CATCLAW ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852969542",
            "telephone_number": "954-614-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 W APACHE TRL STE 101",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851203426",
            "telephone_number": "480-824-7360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2610 SE Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944535",
            "country_code": "US",
            "telephone_number": "772-403-0175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILODEAU",
        "first_name": "JEAN-GUY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002595",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

Verify at the official NPI Registry.