NPIMap

Organization Active NPI

Jeanine Hayen OD LLC

  • Optometrist
  • Orlando, FL
National Provider Identifier
1326595208
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4323 Issued in FL
Legal business name
JEANINE HAYEN OD LLC
Practice address
720 Rugby St
Suite 100
Orlando, FL 32804-4900
Phone
(407) 271-4455
Fax
(407) 271-4147
NPI assigned
Sep 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Authorized official

Name
Jeanine Armesto, O.D.NPI 1851548531
Title
Owner
Phone
(407) 271-4455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 4323 FL Primary

Addresses

Primary practice location

720 Rugby St
Suite 100
Orlando, FL 32804-4900

Mailing address

720 Rugby St
Suite 100
Orlando, FL 32804-4900
Phone (407) 271-4455

Other names 1

  • College Park Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161115002580 FL Part B Supplier - Clinic/Group Practice 4789963703 Receives reassigned benefits from 3 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

720 Rugby St
Ste 100
Orlando, FL 32804
Phone (407) 271-4455

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1326595208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 RUGBY ST",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044900",
            "telephone_number": "407-271-4455",
            "fax_number": "407-271-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 RUGBY ST",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044900",
            "telephone_number": "407-271-4455",
            "fax_number": "407-271-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANINE HAYEN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "ARMESTO",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-271-4455",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Park Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.