Idaayu Ratih Jenisch, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60195908 Issued in WA

Practice address

5101 S 283Rd PL
Auburn, WA 98001-1927

Phone

(253) 520-2100

NPI assigned

Sep 19, 2009

Last updated

Mar 3, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Idaayu Ratih Jenisch Other name

Medicare fee-for-service enrollment

Enrolled in WA

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

Pacific University - College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jenisch Vision Care PLLC

  • Optometrist
  • Auburn, WA
  • NPI 1407214737
  NPD (past) Authorized official
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1253318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1437483716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 S 283RD PL",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980011927",
            "telephone_number": "253-520-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 S 283RD PL",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980011927",
            "telephone_number": "253-520-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENISCH",
        "first_name": "IDAAYU",
        "middle_name": "RATIH",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-19",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60195908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IDAAYU",
            "last_name": "JENISCH",
            "middle_name": "RATIH",
            "prefix": "MRS.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jean-Paul Banh, DDS, PLLC
• Ina Jeanotte
• Jeffrey J Matson DDS Inc
• Connie Marie Jeffries, CDP
• Jenisch Vision Care PLLC
• John Michael Jennings Jr., LMHC
• Michael J Jensen, P.A.
• Lindsay Willene Gerken Jett
• Jill Turner M D P S
• Shawnelle Ilona Johansen

• Optometrist in Auburn, WA
• Providers in Auburn, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.