Individual provider Active NPI

Jeff Jeskin, OD

  • Optometrist
  • Gretna, LA
National Provider Identifier
1174670335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
740-132T Issued in LA
Practice address
197 Westbank Expy
Gretna, LA 70053-2459
Phone
(504) 365-8323
Fax
(504) 361-4277
NPI assigned
Jan 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 740-132T LA Primary

Addresses

Primary practice location

197 Westbank Expy
Gretna, LA 70053-2459

Mailing address

11103 West Ave
Ste 6
San Antonio, TX 78213-1370
Phone (210) 524-6803

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
740LAMDMarriage & Family Therapist
740-132TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason Wonch, O.D. and Associates, a.P.C. Optometrist Past Accepting new patients

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174670335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "STE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6803",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 WESTBANK EXPY",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700532459",
            "telephone_number": "504-365-8323",
            "fax_number": "504-361-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESKIN",
        "first_name": "JEFF",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "740-132T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.