Individual provider Active NPI

Jennifer Kleyn, OD

  • Optometrist
  • Jenison, MI
National Provider Identifier
1215627732
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005678 Issued in MI
Practice address
597 Baldwin St Ste 1
Jenison, MI 49428-7994
Phone
(616) 457-0760
NPI assigned
May 9, 2023
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005678 MI Primary

Addresses

Primary practice location

597 Baldwin St Ste 1
Jenison, MI 49428-7994

Mailing address

597 Baldwin St Ste 1
Jenison, MI 49428-7994

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230714003490 MI Practitioner - Optometry 1951761436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avery Vision Center PCGroup PAC ID 5698851319, 5 clinicians

Practice addresses (Care Compare)

1002 N US Hwy 27
Saint Johns, MI 48879-1129
Phone (989) 224-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005678MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Avery Vision Center PC Optometrist CurrentSince Jun 1, 2023 Accepting new patients

Locations

1000 E Sturgis St
Ste 3
Saint Johns, MI 48879
Phone (517) 224-6729

1002 N US Highway 27
Saint Johns, MI 48879
Phone (989) 224-1452

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1215627732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 BALDWIN ST STE 1",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 BALDWIN ST STE 1",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287994",
            "telephone_number": "616-457-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEYN",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

Verify at the official NPI Registry.