Jennifer Havrilla, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0002925 Issued in CO

Practice address

425 Crows Nest CT
Fort Collins, CO 80525-3118

Phone

(970) 629-1325

NPI assigned

Jun 7, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Pacific University - College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennifer Havrilla LLCGroup PAC ID 4880936624, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Jennifer Havrilla LLC

  • Optometrist
  • Fort Collins, CO
  • NPI 1114484656
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479945600000",
    "number": "1134480973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 CROWS NEST CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253118",
            "telephone_number": "970-629-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 CROWS NEST CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253118",
            "telephone_number": "970-629-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVRILLA",
        "first_name": "JENNIFER",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2016-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0002925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valeri Hauser, LPN
• Kaitlyn Havenner, RD
• Cassity Haverkamp
• Derek Haverley, PT, DPT
• Reese Havoc, MA, LPC
• Larry Eugene Hawe, PHARMACIST
• Brooke Hawkins
• Nathan R Hawkins, PA.C
• Tanya Hawkins, LMT
• Renae Hawkos, LMT

• Optometrist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2016; 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.