Individual provider Active NPI

Jessica Lin Nilsson, O.D.

  • Optometrist
  • Virginia Beach, VA
National Provider Identifier
1447411996
Registry record updated Feb 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001750 Issued in VA
Practice address
2000 General Booth Blvd
Suite 104
Virginia Beach, VA 23454-5876
Phone
(757) 426-2020
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001750 VA Primary

Addresses

Primary practice location

2000 General Booth Blvd
Suite 104
Virginia Beach, VA 23454-5876

Mailing address

2000 General Booth Blvd
Suite 104
Virginia Beach, VA 23454-5876
Phone (757) 426-2020

Other names 1

  • Jessica Yuiching Lin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20080721000627 VA Practitioner - Optometry 8123191376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearview Eye Care, IncGroup PAC ID 0345630729, 7 clinicians

Practice addresses (Care Compare)

1116 Volvo Pkwy
Suite 102
Chesapeake, VA 23320-2803
Phone (757) 275-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361664000000",
    "number": "1447411996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GENERAL BOOTH BLVD",
            "address_2": "SUITE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545876",
            "telephone_number": "757-426-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GENERAL BOOTH BLVD",
            "address_2": "SUITE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545876",
            "telephone_number": "757-426-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "JESSICA",
        "middle_name": "LIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2013-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LIN",
            "middle_name": "YUICHING",
            "credential": "O.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.