Jeffna Elavumkal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4071-35 Issued in WI

Practice address

9916 75TH St Ste 101
Kenosha, WI 53142-7583

Phone

(262) 658-1937

NPI assigned

Apr 14, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Optometry

Education

Southern College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Centers of Racine and Kenosha LTDGroup PAC ID 8921069048, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Centers of Racine and Kenosha LTD

  • Ophthalmology Physician
  • Mount Pleasant, WI
  • NPI 1710905781

  Optometrist

  Medicare reassignment Care Compare group NPD
• Eye Centers of Racine and Kenosha LTD

  • Ophthalmology Physician
  • Mount Pleasant, WI
  • NPI 1558232926
  NPD

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1699560169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 ASHLAND AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166118",
            "telephone_number": "224-703-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9916 75TH ST STE 101",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427583",
            "telephone_number": "262-658-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAVUMKAL",
        "first_name": "JEFFNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4071-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daelah Edwards
• Kelly Ehnert-Horbinski, APSW
• Nicole Eide
• Romi Eide
• Nancy Sue Eisner
• Nichole M Elcano, DDS
• Eugene John Eldridge, M.D.
• Mary Patricia Eldridge, M.D.
• Arneetrice Ellerman, COMS
• Erin Ellsworth, APNP

• Optometrist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.