Brian Christopher Jacks, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

60097178 Issued in WA

Practice address

7903 W Grandridge Blvd Ste a
Kennewick, WA 99336-7827

Phone

(509) 783-0667

Fax

(509) 735-7981

NPI assigned

Jul 2, 2009

Last updated

Jul 2, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WA

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

Pacific University - College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Eye Care PSGroup PAC ID 4880688423, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Eye Care PS

  • Optometrist
  • Kennewick, WA
  • NPI 1629297171
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1346479011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7903 W GRANDRIDGE BLVD STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367827",
            "telephone_number": "509-783-0667",
            "fax_number": "509-735-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7903 W GRANDRIDGE BLVD STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367827",
            "telephone_number": "509-783-0667",
            "fax_number": "509-735-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "BRIAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60097178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Rene Iturriaga, DPD
• Katy Ybarra-Guzman Izaguirre, MA
• J Makovsky Counseling LLC
• Irene Jacinto
• Denise Joann Jackman, RPH
• Daniel Leroy Jacks, O.D.
• Victoria Lynn Jackson
• Connie Davis Jacob, MA CCC-SLP
• Amy Jacobs
• Joel Dale Jacobs, DMD

• Optometrist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.