Individual provider Active NPI

Jeffrey David Brown, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1184699571
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4005 Issued in FL
Practice address
5255 Dunn Ave
Jacksonville, FL 32218-4361
Phone
(904) 757-1495
Fax
(904) 757-1497
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4005 FL Primary

Addresses

Primary practice location

5255 Dunn Ave
Jacksonville, FL 32218-4361

Mailing address

201 N Hogan St Ste 100
Jacksonville, FL 32202-4203
Phone (904) 757-1495

Other identifiers 7

IdentifierTypeStateIssuer
7223289OtherAETNA
2615561OtherUHC
8677011OtherCIGNA
0135179OtherGHI
P00424970OtherFLMEDICARE RR PTAN
621210700OtherFLMEDICAID INDIVIDUAL ID
01029OtherFLBCBS INDIVIDUAL ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20060209000650 FL Practitioner - Optometry 0345255402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jax Vision Care, PAGroup PAC ID 8426185927, 4 clinicians

Practice addresses (Care Compare)

201 N Hogan St
Suite 100
Jacksonville, FL 32202-4203
Phone (904) 356-9431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jax Vision Care, PA Optometrist CurrentSince Mar 1, 2010 Accepting new patients

Locations

5255 Dunn Ave
Jacksonville, FL 32218
Phone (904) 751-6211

201 N Hogan St
Ste 100
Jacksonville, FL 32202
Phone (904) 356-9431

2255 Dunn Ave
Ste 101B
Jacksonville, FL 32218

30 Tavernier Dr
Ste C
Ponte Vedra, FL 32081
Phone (904) 356-9431

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1184699571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N HOGAN ST STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024203",
            "telephone_number": "904-757-1495",
            "fax_number": "904-757-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184361",
            "telephone_number": "904-757-1495",
            "fax_number": "904-757-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7223289",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2615561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8677011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0135179",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "P00424970",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID INDIVIDUAL ID",
            "identifier": "621210700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL ID",
            "identifier": "01029",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.