Jillian Penney, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003722 Issued in PA

Practice address

1201 W Elm Ave
Hanover, PA 17331-4600

Phone

(717) 630-2922

NPI assigned

May 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Pennsylvania Professional IncGroup PAC ID 7719218593, 80 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aeg Pennsylvania Professional Inc

  dba Eyes on Regent Square

  • Optometrist
  • Pittsburgh, PA
  • NPI 1851958854
  Medicare reassignment Care Compare group NPD
• Aeg Pennsylvania Professional, Inc

  dba Eyetique -Shadyside

  • Optometrist
  • Pittsburgh, PA
  • NPI 1932604220
  NPD (past)

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1245853563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BEACHFIELD LN",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173313552",
            "telephone_number": "570-262-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W ELM AVE",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173314600",
            "telephone_number": "717-630-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEY",
        "first_name": "JILLIAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Pelakh
• Steven Pellas, PTA
• Penn Township Volunteer Emergency Service
• Penn Township Volunteer Emergency Services
• Penncares
• Pennsylvania Center for Dental Sleep Medicine PC
• Pennsylvania CVS Pharmacy LLC (CVS Pharmacy #17577)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01653)
• Lauren P Penrose, PA-C
• Anganette Perkins, CRNP

• Optometrist in Hanover, PA
• Providers in Hanover, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.