Jacqueline M Donahue, OD

Key facts

NPI

1417110396

Entity type

Individual (NPI type 1)

Primary specialty

Optometrist 152W00000X

License

622 (NV)

Practice address

500 W Plumb LN Ste a
Reno, NV 89509-3688

Phone

(775) 284-3937

NPI assigned

Jul 9, 2008

Sex

Female

Sole proprietor

No

Organizations & group practices 7

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.

• Michelle Wong Optometry PC Optometrist · Reno, NV · NPI 1780233460
  Medicare reassignment NPD NV · OPTOMETRIST
• Michelle Wong Optometry PC Optometrist · Reno, NV · NPI 1770256000
  NPD OPTOMETRIST
• Pritchett Eye Care PC Optometrist · Reno, NV · NPI 1225343965
  NPD OPTOMETRIST
• Pritchett Eye Care PC Optometrist · Sparks, NV · NPI 1679889372
  NPD OPTOMETRIST
• Pritchett Eye Care PC Optometrist · Pahrump, NV · NPI 1730664327
  NPD OPTOMETRIST
• Pritchett Eye Care PC Optometrist · Fernley, NV · NPI 1952962375
  NPD (past) OPTOMETRIST
• Pritchett Eye Care PC Optometrist · Sparks, NV · NPI 1962717603
  NPD (past) OPTOMETRIST

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2023.

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1417110396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985",
            "telephone_number": "614-784-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W PLUMB LN STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093688",
            "telephone_number": "775-284-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF OPTOMETRY",
            "identifier": "622",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417110396",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Reno, NV · Optometrist in Nevada