Jennifer Brave Rafati, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2008017085 Issued in MO

Practice address

2100 Troy Rd Ste 104
Edwardsville, IL 62025-2595

Phone

(618) 656-8888

Fax

(618) 656-8920

NPI assigned

Jun 25, 2008

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 2

Other names 1

• Dr. Jennifer Brave Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

University of Missouri St Louis - School of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry Illinois, PCGroup PAC ID 7012292147, 16 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenniferrafati@direct.eyecare-partners.com

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.

• Clarkson Optometry Illinois, P.C.

  • Optometrist
  • Ballwin, MO
  • NPI 1548635758

  IL

  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Illinois, P.C.

  • Optometrist
  • Centralia, IL
  • NPI 1730373648
  NPD
• Clarkson Optometry Illinois PC

  • Optometrist
  • Shiloh, IL
  • NPI 1457303125
  NPD (past)
• Nu-Crown, LLC

  • Optometrist
  • Alton, IL
  • NPI 1295737294
  NPD (past)
• Clarkson Eyecare

  • Optometrist
  • Eureka, MO
  • NPI 1205817731
  NPD (past)

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1184886731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 TROY RD STE 104",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252595",
            "telephone_number": "618-656-8888",
            "fax_number": "618-656-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 TROY RD STE 104",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252595",
            "telephone_number": "618-656-8888",
            "fax_number": "618-656-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFATI",
        "first_name": "JENNIFER",
        "middle_name": "BRAVE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2008017085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0460100111",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184886731",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BRAVE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.