Jonathan Paul Judisch, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

02262 Issued in IA

Practice address

1341 W Main St
Lake City, IA 51449-0124

Phone

(712) 464-3136

Fax

(712) 464-7683

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

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

Illinois College of Optometry at Chicago, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drjudisch@eyeclinicdirect.net

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.

• Judisch Vision PC

  • Optometrist
  • Lake City, IA
  • NPI 1669521027
  Medicare reassignment Authorized official
• Judisch Vision PC

  • Optometrist
  • Lake View, IA
  • NPI 1427103902
  NPD Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1285784280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 W MAIN ST",
            "address_2": "PO BOX 124",
            "city": "LAKE CITY",
            "state": "IA",
            "postal_code": "514490124",
            "telephone_number": "712-464-3136",
            "fax_number": "712-464-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W MAIN ST",
            "city": "LAKE CITY",
            "state": "IA",
            "postal_code": "514490124",
            "telephone_number": "712-464-3136",
            "fax_number": "712-464-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDISCH",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025030700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35539",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418657",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00052944",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey P Hood, T-LMHC
• Susan A Hornback, DO
• Megan M Huster
• Jeremy C Johnson, CRNA
• Judisch Vision PC
• Jeremie Lee Kent
• Yotin Keonin, MD
• Julie R Kraft, RPH
• Larry Lee Kruthoff, RPH
• Lake City Chiropractic Office

• Optometrist in Lake City, IA
• Providers in Lake City, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.