Individual provider Active NPI

Jill Ann Kayner, OD

  • Optometrist
  • St Clair Shores, MI
National Provider Identifier
1336280320
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004007 Issued in MI
Practice address
29519 Harper Avenue
St Clair Shores, MI 48081
Phone
(586) 772-8140
Fax
(586) 772-8307
NPI assigned
Feb 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004007 MI Primary

Addresses

Primary practice location

29519 Harper Avenue
St Clair Shores, MI 48081

Mailing address

29519 Harper Avenue
St Clair Shores, MI 48081
Phone (586) 772-8140

Other identifiers 1

IdentifierTypeStateIssuer
4901004007OtherMISTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070713000791 MI Practitioner - Optometry 4587764972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SVS Vision IncGroup PAC ID 9931257110, 41 clinicians

Practice addresses (Care Compare)

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7612

30120 Harper Ave
Saint Clair Shores, MI 48082-1611
Phone (586) 778-7542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince Apr 1, 2013 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Apr 1, 2013 Accepting new patients

Locations

2555 Jackson Ave
Ann Arbor, MI 48103
Phone (734) 239-8900

6602 Telegraph Rd
Bloomfield Hills, MI 48301
Phone (248) 419-3500

34505 Utica Rd
Fraser, MI 48026
Phone (586) 293-4198

2023 W 8 Mile Rd
Highland Park, MI 48203
Phone (313) 365-3300

355 S Broadway St
Lake Orion, MI 48362
Phone (248) 693-8666

106 W 12 Mile Rd
Madison Heights, MI 48071
Phone (248) 414-1900

1314 N Telegraph Rd
Monroe, MI 48162
Phone (734) 243-0195

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

30120 Harper Ave
Saint Clair Shores, MI 48082
Phone (586) 778-7542

52799 Hayes Rd
Shelby Township, MI 48315
Phone (586) 247-2652

37120 Dequindre Rd
Sterling Heights, MI 48310
Phone (586) 979-6260

36824 Van Dyke Ave
Sterling Heights, MI 48312
Phone (586) 276-9300

22320 Goddard Rd
Taylor, MI 48180
Phone (313) 299-8870

3110 Van Horn Rd
Trenton, MI 48183
Phone (734) 675-8197

29660 S Wixom Rd
Wixom, MI 48393
Phone (248) 313-5500

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": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1336280320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29519 HARPER AVENUE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-772-8140",
            "fax_number": "586-772-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29519 HARPER AVENUE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-772-8140",
            "fax_number": "586-772-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYNER",
        "first_name": "JILL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4901004007",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.