Individual provider Active NPI

Jordan Anne Richardson, O.D.

  • Optometrist
  • Oshkosh, WI
National Provider Identifier
1346698529
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3961-35 Issued in WI
Practice address
700 N Westhaven Dr
Oshkosh, WI 54904
Phone
(920) 303-8700
NPI assigned
May 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3961-35 WI Primary
Optometrist 152W00000X 34181 CA

Addresses

Primary practice location

700 N Westhaven Dr
Oshkosh, WI 54904

Mailing address

PO Box 735044
Chicago, IL 60673
Phone (800) 326-2250

Other practice location 1

1044B N El Camino Real
Encinitas, CA 92024
Phone (760) 479-9812

Other identifiers 1

IdentifierTypeStateIssuer
100293138MedicaidWI

Other names 1

  • Jordan Anne Pinozek Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jrichardson411376@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20241030001560 WI Practitioner - Optometry 9931496288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

700 N Lake Ave
Suite 102
Twin Lakes, WI 53181-9436
Phone (262) 877-2124

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34181CAMDHealth Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Gary M. Moss, O.D. PastSince Aug 18, 2016 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

700 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 456-2030

700 N Lake Ave
Ste 102
Twin Lakes, WI 53181
Phone (262) 877-2124

Interoperability endpoints

  • Direct secure messaging: jrichardson411376@direct.myadvocateaurora.org
  • Direct secure messaging: jordanpinozekod@clavennavision.direct.eyemdemr.com

Organizations & group practices 5

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": "1464480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1346698529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60673",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-303-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044B N El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "92024",
            "country_code": "US",
            "telephone_number": "760-479-9812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JORDAN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-29",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3961-35",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100293138",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrichardson411376@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "700 N Westhaven Dr",
            "city": "OSHKOSH",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "700 N Westhaven Dr",
            "city": "OSHKOSH",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "PINOZEK",
            "middle_name": "ANNE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.