Jaclyn Ann Keller, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3228-35 Issued in WI

Practice address

126 Charles St
Oconto, WI 54153-9446

Phone

(920) 834-5251

NPI assigned

Jun 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jaclyn Ann Saltee Former name

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Eye AssociatesGroup PAC ID 5395633580, 25 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.

• Valley Eye Associates

  • Optometrist
  • Appleton, WI
  • NPI 1699789032
  Medicare reassignment Care Compare group NPD
• Park Place Optical, LTD

  • Optician
  • Appleton, WI
  • NPI 1255465738
  NPD (past)
• Shopko Stores Operating Co LLC

  • Community/Retail Pharmacy
  • Eau Claire, WI
  • NPI 1720034176
  NPD (past)

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1154617652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CHARLES ST",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541539446",
            "telephone_number": "920-834-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 CHARLES ST",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541539446",
            "telephone_number": "920-834-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JACLYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3228-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SALTEE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John S Honish, MD
• Nathan W Jackson, DC
• Briana Jones
• Matthew James Karban, DDS
• Clayton W Keene, FNP
• Jessica Kerwin
• Thomas J. Knutson, MD
• Jonathan Koby
• Susan M Koeune, BSW
• Kimberly Marie Kudwa, APNP

• All providers in Oconto, WI
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.