Individual provider Active NPI

Jillian G Dinan

  • Optometrist
  • Canandaigua, NY
National Provider Identifier
1316389448
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008109 Issued in NY
Practice address
325 West St
Canandaigua, NY 14424-1787
Phone
(585) 394-2020
Fax
(585) 394-9261
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008109 NY Primary

Addresses

Primary practice location

325 West St
Canandaigua, NY 14424-1787

Mailing address

325 West St
Canandaigua, NY 14424-1787
Phone (585) 394-2020

Other practice location 1

784 Pre Emption Rd
Geneva, NY 14456-2092
Phone (585) 394-2020

Other practice location 2

1210 Driving Park Ave
Newark, NY 14513-1057
Phone (585) 394-2020

Other identifiers 1

IdentifierTypeStateIssuer
03875972MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jillianboltonod@theeyecarecenter.medentdirect.com Direct
Direct Messaging Address jillianboltonod@theeyecarecenter.medentdirect.com Direct
Direct Messaging Address jillianboltonod@theeyecarecenter.medentdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140620001071 NY Practitioner - Optometry 8325262942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Finger Lakes Ophthalmology, PCGroup PAC ID 9436140019, 12 clinicians

Practice addresses (Care Compare)

325 W St
Canandaigua, NY 14424-1787
Phone (585) 394-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008109NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Finger Lakes Ophthalmology, PC Optometrist CurrentSince Jul 1, 2014 Accepting new patients
Finger Lakes Ophthalmology, PC Past Accepting new patients

Locations

325 West St
Ste 105
Canandaigua, NY 14424

325 West St
Canandaigua, NY 14424
Phone (585) 394-2020

784 Pre Emption Rd
Geneva, NY 14456
Phone (315) 787-7337

1025 Brixton Dr
Macedon, NY 14502
Phone (315) 986-4022

1210 Driving Park Ave
Newark, NY 14513
Phone (315) 331-8921

Interoperability endpoints

  • Direct secure messaging: jilliandinanod@theeyecarecenter.medentdirect.com

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1316389448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241787",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241787",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "784 Pre Emption Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562092",
            "country_code": "US",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 Driving Park Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131057",
            "country_code": "US",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINAN",
        "first_name": "JILLIAN",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03875972",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jillianboltonod@theeyecarecenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR e-mail address for secure sharing of patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "784 Pre Emption Rd",
            "city": "Geneva",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144562092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jillianboltonod@theeyecarecenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR e-mail address for secure sharing of patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "325 West St",
            "city": "Canandaigua",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144241787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jillianboltonod@theeyecarecenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR e-mail address for secure sharing of patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1210 Driving Park Ave",
            "city": "Newark",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145131057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.