Jerome Weitzen OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

700 Issued in FL

Legal business name

JEROME WEITZEN OD PA

Practice address

213 N Laura St
Jacksonville, FL 32202-3501

Phone

(904) 353-3163

Fax

(904) 355-1813

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Weitzen, ODNPI 1730369232

Title

Pres

Phone

(904) 353-3163

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Jerome Weitzen

  • Optometrist
  • Jacksonville, FL
  • NPI 1730369232
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Beth Weitzen, O.D.

  • Optometrist
  • Jacksonville, FL
  • NPI 1770775900
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247011200000",
    "number": "1346288339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023501",
            "telephone_number": "904-353-3163",
            "fax_number": "904-355-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023501",
            "telephone_number": "904-353-3163",
            "fax_number": "904-355-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME WEITZEN OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-07-08",
        "status": "A",
        "authorized_official_last_name": "WEITZEN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "904-353-3163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084160900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jericho School for Children With Autism, Inc.
• Camika S Jerido
• Shantell Jerido
• Jerin Joseph OD, PA
• Kelsey Jernigan
• Magdala Jerome-Saintil
• Jazmin L Jerome, MSW, RCSWI
• Abdallah Mohamed Jeroudi, MD
• Julie Jerue, MSN, RN, LMT, CHT
• Lisa Jessamine, OT

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.