Individual provider Active NPI

Jessica Marie Berry, OD

  • Optometrist
  • Hanover, NH
National Provider Identifier
1245887181
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0995 Issued in NH
Practice address
45 Lyme Rd Ste 201
Hanover, NH 03755-1260
Phone
(603) 643-2140
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0995 NH Primary

Addresses

Primary practice location

45 Lyme Rd Ste 201
Hanover, NH 03755-1260

Mailing address

29 Beech St Apt B
Newport, NH 03773-1414
Phone (978) 766-3217

Other practice location 1

587 Hartford Ave
White River Junction, VT 05001-8031
Phone (802) 295-4887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191023001791 NH Practitioner - Optometry 2264764323 Reassigns benefits to 2 organizations
I20200929001472 VT Practitioner - Optometry 2264764323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dufour Vision Care PLLCGroup PAC ID 7719498567, 5 clinicians
White River Family Eyecare, PCGroup PAC ID 7911910096, 3 clinicians

Practice addresses (Care Compare)

45 Lyme Rd
Suite 201
Hanover, NH 03755-1260
Phone (603) 643-2140

587 Hartford Ave
White River Junction, VT 05001-8031
Phone (802) 295-4887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0995NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
White River Family Eyecare, PC Optometrist CurrentSince Sep 1, 2019 Accepting new patients
Dufour Vision Care PLLC Optometrist CurrentSince May 12, 2025 Accepting new patients

Locations

45 Lyme Rd
Ste 201
Hanover, NH 03755
Phone (603) 643-2140

587 Hartford Ave
White River Junction, VT 05001
Phone (802) 295-4887

Organizations & group practices 2

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1245887181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BEECH ST APT B",
            "city": "NEWPORT",
            "state": "NH",
            "postal_code": "037731414",
            "telephone_number": "978-766-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LYME RD STE 201",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551260",
            "telephone_number": "603-643-2140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "587 Hartford Ave",
            "address_purpose": "LOCATION",
            "city": "White River Junction",
            "state": "VT",
            "postal_code": "050018031",
            "country_code": "US",
            "telephone_number": "802-295-4887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, NH

Sources for this page

Verify at the official NPI Registry.