Individual provider Active NPI

Jacob Burton, O.D

  • Optometrist
  • Columbia, KY
National Provider Identifier
1629324918
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY1893DT Issued in KY
Practice address
301 Burkesville Street
Columbia, KY 42728-1921
Phone
(270) 384-6043
Fax
(270) 384-0672
NPI assigned
Jul 24, 2012
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KY1893DT KY Primary

Addresses

Primary practice location

301 Burkesville Street
Columbia, KY 42728-1921

Mailing address

301 Burkesville Street
Columbia, KY 42728-1921
Phone (270) 384-6043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120921000641 KY Practitioner - Optometry 0941456800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downey Eye Clinic, PLLCGroup PAC ID 9830561117, 4 clinicians

Practice addresses (Care Compare)

1463 Campbellsville Rd
Columbia, KY 42728-2263
Phone (270) 384-6043

Merit-based Incentive Payment System (MIPS)

Final score
69.32 of 100Reported as individual
Quality
54.03
Promoting interoperability
82
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY1893DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Downey Eye Clinic, PLLC Optometrist CurrentSince Feb 20, 2022 Accepting new patients

Locations

1463 Campbellsville Rd
Columbia, KY 42728
Phone (270) 384-6043

310 Steve Dr
Ste 1
Russell Springs, KY 42642
Phone (270) 866-4414

Organizations & group practices 3

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1629324918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BURKESVILLE STREET",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281921",
            "telephone_number": "270-384-6043",
            "fax_number": "270-384-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BURKESVILLE STREET",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281921",
            "telephone_number": "270-384-6043",
            "fax_number": "270-384-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY1893DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, KY

Sources for this page

Verify at the official NPI Registry.