Individual provider Active NPI

Jaclyn McKnight, O.D.

  • Optometrist
  • Largo, FL
National Provider Identifier
1285171272
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 5315 Issued in FL
Practice address
800 E Bay Dr
Suite G
Largo, FL 33770-2532
Phone
(727) 585-8521
NPI assigned
Jan 27, 2017
Last updated
Feb 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 5315 FL Primary

Addresses

Primary practice location

800 E Bay Dr
Suite G
Largo, FL 33770-2532

Mailing address

14967 Imperial Point Dr N
Largo, FL 33774-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170512000918 FL Practitioner - Optometry 6507143971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

11290 Park Blvd
Suite B
Seminole, FL 33772-4865
Phone (727) 374-5121

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 5315FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Apr 25, 2017 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Apr 25, 2017 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Past Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Past Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Past Accepting new patients

Locations

3740 Park Blvd N
Pinellas Park, FL 33781
Phone (727) 547-4856

6901 22nd Ave N
Rm 760
St Petersburg, FL 33710
Phone (727) 343-3006

6927 4th St N
St Petersburg, FL 33702
Phone (727) 210-8672

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1285171272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14967 IMPERIAL POINT DR N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337744912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E BAY DR",
            "address_2": "SUITE G",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702532",
            "telephone_number": "727-585-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "JACLYN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.