NPIMap

Individual provider Active NPI

Jennifer Jacobson Turcott, OD

  • Optometrist
  • Cumberland, WI
National Provider Identifier
1689674616
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WI-2594 Issued in WI
Practice address
1357 2ND Ave
Cumberland, WI 54829-7211
Phone
(715) 822-2091
Fax
(715) 822-3624
NPI assigned
Aug 1, 2005
Last updated
Dec 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X WI-2594 WI Primary

Addresses

Primary practice location

1357 2ND Ave
Cumberland, WI 54829-7211

Mailing address

PO Box 250
Cumberland, WI 54829-0250
Phone (715) 822-2091

Other identifiers 3

IdentifierTypeStateIssuer
38593200MedicaidWI
410040876OtherWIRR-PTAN 410040876
410028306OtherWIRR-PTAN 410028306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110518000101 WI Practitioner - Optometry 6800902792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Wisconsin Professional LTDGroup PAC ID 1557372968, 16 clinicians

Practice addresses (Care Compare)

1357 2ND Ave
Cumberland, WI 54829-7211
Phone (715) 822-2091

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WI-2594WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Wisconsin Professional LTD Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Lee R Jacobson OD SC Past Accepting new patients
St Croix Falls Eye Associates Inc. Optometrist Past Accepting new patients
Lee R Jacobson Past Accepting new patients

Locations

2215 Vine St
Ste E
Hudson, WI 54016
Phone (715) 381-1234

Interoperability endpoints

  • Direct secure messaging: jjacobsonturcott@direct.revolutionehr.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cumberland HealthcareCumberland, WI, CCN 521353 Hospital Corporate Director Feb 1, 2020
Cumberland Memorial Hospital IncCumberland, WI, CCN 52Z353 Hospital Corporate Officer Jul 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1689674616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "CUMBERLAND",
            "state": "WI",
            "postal_code": "548290250",
            "telephone_number": "715-822-2091",
            "fax_number": "715-822-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 2ND AVE",
            "city": "CUMBERLAND",
            "state": "WI",
            "postal_code": "548297211",
            "telephone_number": "715-822-2091",
            "fax_number": "715-822-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURCOTT",
        "first_name": "JENNIFER",
        "middle_name": "JACOBSON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "WI-2594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38593200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR-PTAN 410040876",
            "identifier": "410040876",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR-PTAN 410028306",
            "identifier": "410028306",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, WI

Sources for this page

Verify at the official NPI Registry.