Jill Lynn Robertson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

105610199934 Issued in UT

Practice address

2700 Homestead Rd Ste 30
Park City, UT 84098-4874

Phone

(435) 615-0435

Fax

(435) 604-0261

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Merit-based Incentive Payment System (MIPS)

Final score

78.39 of 100Reported as group

Quality

56.78

Improvement activities

40

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 and National Provider Directory roles.

• DRS Bowling Griffith & Antle Optometrists PC

  • Optometrist
  • Branson, MO
  • NPI 1861478679
  Medicare reassignment NPD
• Lakeside Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Springdale, AR
  • NPI 1396634820
  NPD
• DRS Bowling Griffith & Antle Optometrists PC

  • Optometrist
  • Ava, MO
  • NPI 1326140187
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1407966765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W HOMESTEAD ROAD, SUITE 30",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-615-0435",
            "fax_number": "435-604-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HOMESTEAD RD STE 30",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840984874",
            "telephone_number": "435-615-0435",
            "fax_number": "435-604-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JILL",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "105610199934",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2555",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49941",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189694722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosalie Ripley
• Rise Park City PLLC
• Rite Aid
• Road Home Group LLC
• Melinda S Roalstad, PAC
• Charles Edward Robinson, M.F.T.
• Richard Stuart Robinson, LCSW
• Jessica Michelle Truskowski Robnett, PSYD
• Susana Rodriguez Patino
• Annie Joanna Rodriguez

• Optometrist in Park City, UT
• Providers in Park City, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.