Jennifer Elam, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1607DT Issued in KY

Practice address

3560 Pine Grove Ave
Ste 366
Port Huron, MI 48060-1994

Phone

(502) 759-1123

NPI assigned

Sep 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Jennifer Dunn Former name

Medicare fee-for-service enrollment

Enrolled in MN, MI, WI3 enrollments

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 3

Merit-based Incentive Payment System (MIPS)

Final score

92.82 of 100Reported as group

Quality

61.63

Promoting interoperability

100

Improvement activities

40

Cost

81.1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.elam.p16@direct.360care.nextgenshare.com

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.

• Onsight, Inc.

  • Podiatrist
  • East Lansing, MI
  • NPI 1821248568
  Medicare reassignment NPD
• Visionworks, Inc

  • Optometrist
  • Rochester Hills, MI
  • NPI 1366822991
  Medicare reassignment NPD
• Patient Centered Eye Care of Minnesota LLC

  • Optometrist
  • Minneapolis, MN
  • NPI 1366863862
  NPD Authorized official
• Onsight, Inc.

  • Dentist
  • East Lansing, MI
  • NPI 1730339474
  NPD
• Onsight, Inc.

  • Optometrist
  • East Lansing, MI
  • NPI 1831356807
  NPD
• Giaimo Mobile Podiatry of WV PLLC

  • Podiatrist
  • Charleston, WV
  • NPI 1386183473
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1356443261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 PINE GROVE AVE",
            "address_2": "STE 366",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601994",
            "telephone_number": "502-759-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 PINE GROVE AVE",
            "address_2": "STE 366",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601994",
            "telephone_number": "502-759-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1607DT",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "KY",
            "license": "1607DT",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "KY",
            "license": "1607DT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DUNN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kristin Marie Elliott, ACNP-BC
• Yehia Ibraham Elsafy, MD

• Optometrist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.