Jenna Elise Stoddard, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005923 Issued in MI

Practice address

2848 Niles Rd
Saint Joseph, MI 49085-3352

Phone

(269) 428-3300

Fax

(269) 428-5005

NPI assigned

Jul 26, 2018

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Eye Care PCGroup PAC ID 8426091992, 12 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.

• Great Lakes Eye Care PC

  • Ophthalmology Physician
  • Saint Joseph, MI
  • NPI 1922002708

  Optometrist

  Medicare reassignment Care Compare group NPD
• Risk Optometric Associates, PA

  • Optometrist
  • Fayetteville, NC
  • NPI 1073584157
  NPD
• Northgate Eye Center O D P a

  • Optometrist
  • Fort Bragg, NC
  • NPI 1699936906
  NPD (past)

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1184101602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853352",
            "telephone_number": "269-428-3300",
            "fax_number": "269-428-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853352",
            "telephone_number": "269-428-3300",
            "fax_number": "269-428-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Longmeadow Village Dr",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491207808",
            "country_code": "US",
            "telephone_number": "269-684-6400",
            "fax_number": "269-684-5103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "JENNA",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSING DIVISION BUREAU OF PROFESSIONAL LICENSING OPTOMETRY LICENSE",
            "identifier": "4901005923",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Stillman, D.O.
• Nathaniel Stine
• Kelly Stipe, DPT
• Sarah Stocker
• Alexander Ray Stoddard, MD
• Stuart Boekeloo, DDS, PC
• Stull Chiropractic PLC
• Kathlynn Jon Stull, D.C.
• Michael Joseph Stusick, D.D.S.P.C.
• Ted Sugimoto, MD

• Optometrist in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.