Individual provider Active NPI

Jerilyn Ann McQuitty, O.D.

  • Optometrist
  • Carmel, IN
National Provider Identifier
1508972506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002388B Issued in IN
Practice address
2001 E 151St St
Carmel, IN 46033-7737
Phone
(317) 844-0613
Fax
(317) 844-0632
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002388B IN Primary

Addresses

Primary practice location

2001 E 151St St
Carmel, IN 46033-7737

Mailing address

14405 Cherry Tree Rd
Carmel, IN 46033-9614
Phone (317) 574-9679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100326000048 IN Practitioner - Optometry 4789710039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deen McQuitty P.C.Group PAC ID 3971639212, 2 clinicians

Practice addresses (Care Compare)

2001 E 151St St
Carmel, IN 46033-7737
Phone (317) 844-0613

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002388BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Deen McQuitty P.C. Optometrist CurrentSince Dec 13, 2009 Accepting new patients

Locations

2001 E 151st St
Carmel, IN 46033
Phone (317) 844-0613

1920 E Markland Ave
Kokomo, IN 46901
Phone (765) 456-3641

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508972506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14405 CHERRY TREE RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339614",
            "telephone_number": "317-574-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E 151ST ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460337737",
            "telephone_number": "317-844-0613",
            "fax_number": "317-844-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUITTY",
        "first_name": "JERILYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002388B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.