Zachary Shawn Jacoby, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.007143 Issued in OH

Practice address

4620 Woodville Rd
Northwood, OH 43619-1802

Phone

(419) 693-0484

NPI assigned

May 23, 2023

Last updated

May 23, 2023By 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 OH

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

Ohio State University - College of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John T Archer and Associates IncGroup PAC ID 9931193158, 5 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.

• John T Archer & Associates Inc

  dba Premier Vision Group

  • Optometrist
  • Northwood, OH
  • NPI 1821679705
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1396437828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 ALEXANDER RD",
            "city": "PEMBERVILLE",
            "state": "OH",
            "postal_code": "434509483",
            "telephone_number": "419-308-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 WOODVILLE RD",
            "city": "NORTHWOOD",
            "state": "OH",
            "postal_code": "436191802",
            "telephone_number": "419-693-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "ZACHARY",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie J Hall
• Harvey H Rosen & Michael J Crawford
• Alysa Marie Healy
• Rachel Lee Henke, COTA
• Auston Hood, OD
• David Daniel Jacques
• James T Rogozinski Cedar Creek Family Dental Care, Inc.
• John T Archer & Associates Inc (Premier Vision Group)
• Brittanee Nicole Koontz, CNA
• L T C Pharmacy, LLC (L T C Pharmacy, Ohio)

• Optometrist in Northwood, OH
• Providers in Northwood, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.