Individual provider Active NPI

Jacquelyn Anino Lamigo, O.D.

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1568956563
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
144582 Issued in AK
Practice address
9350 Independence Dr
Anchorage, AK 99507-4613
Phone
(907) 561-1167
NPI assigned
Jun 22, 2018
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33946TLG CA
Optometrist 152W00000X 144582 AK Primary

Addresses

Primary practice location

9350 Independence Dr
Anchorage, AK 99507-4613

Mailing address

9350 Independence Drive
Anchorage, AK 99507-4613
Phone (907) 561-1167

Other names 1

  • Southside Eyecare, LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20200617000761 AK Practitioner - Optometry 4880932557 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9350 Independence Dr
Anchorage, AK 99507-4613
Phone 90756111673

Merit-based Incentive Payment System (MIPS)

Final score
81.5 of 100Reported as individual
Quality
80
Promoting interoperability
75
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33946TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Wayne Ogata O.D. Inc. Optometrist PastSince Nov 15, 2009 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1568956563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 INDEPENDENCE DRIVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074613",
            "telephone_number": "907-561-1167",
            "fax_number": "907-561-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 INDEPENDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074613",
            "telephone_number": "907-561-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMIGO",
        "first_name": "JACQUELYN",
        "middle_name": "ANINO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33946TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "144582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOUTHSIDE",
            "last_name": "EYECARE, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.