Individual provider Active NPI

Jaqueline Leann Isquierdo, O.D.

  • Optometrist
  • Santa Fe, NM
National Provider Identifier
1356125173
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-2023-0007 Issued in NM
Practice address
1645 Galisteo St
Santa Fe, NM 87505-4749
Phone
(505) 984-8989
Fax
(505) 984-8892
NPI assigned
Aug 22, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-2023-0007 NM Primary

Addresses

Primary practice location

1645 Galisteo St
Santa Fe, NM 87505-4749

Mailing address

3116 Scenic Dr
Modesto, CA 95355-4771
Phone (209) 499-1842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20231228003908 NM Practitioner - Optometry 8022468339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accent on Vision, Santa Fe LLCGroup PAC ID 3476534686, 4 clinicians

Practice addresses (Care Compare)

1645 Galisteo St
Santa Fe, NM 87505-4749
Phone (505) 984-8989

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-2023-0007NMMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Accent on Vision, Santa Fe LLC Optometrist CurrentSince Nov 15, 2023 Accepting new patients

Locations

1645 Galisteo St
Santa Fe, NM 87505
Phone (505) 984-0694

Interoperability endpoints

  • Direct secure messaging: jisquierdo@accentvision.intellechartdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1356125173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554771",
            "telephone_number": "209-499-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054749",
            "telephone_number": "505-984-8989",
            "fax_number": "505-984-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISQUIERDO",
        "first_name": "JAQUELINE",
        "middle_name": "LEANN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "OPT-2023-0007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.