Jessica Joy Humphrey, OD
Individual provider Active NPI Optometrist · Manchester, MI
NPI 1265300511 · NPPES record last updated Feb 13, 2026
Key facts
- NPI
- 1265300511
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901005920 (MI)
- Practice address
- 110 Riverside Dr
Manchester, MI 48158-9776 - Phone
- (734) 428-2020
- Fax
- (734) 428-8955
- NPI assigned
- Oct 28, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Manchester Eye Care Center, P.C.
Practice addresses (Care Compare)
110 Riverside Dr
Manchester, MI 48158-9776
Phone (734) 428-2020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251107000492 | MI | Practitioner - Optometry | 2860982816 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901005920 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manchester Eye Care Center, P.C. | Current |
Accepting new patients |
Locations
110 Riverside Dr
Manchester, MI 48158
Phone (734) 428-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901005920 | MI | Yes |
Addresses
Primary practice location
110 Riverside Dr
Manchester, MI 48158-9776
Mailing address
110 Riverside Dr
Manchester, MI 48158-9776
Phone (734) 428-2020
Other providers in Manchester, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.