Individual provider Active NPI

Jessica Lo, O.D

  • Optometrist
  • New York, NY
National Provider Identifier
1700228426
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008052 Issued in NY
Practice address
310 E 14TH St
Suite 219
New York, NY 10003-4201
Phone
(212) 505-6650
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008052 NY Primary

Addresses

Primary practice location

310 E 14TH St
Suite 219
New York, NY 10003-4201

Mailing address

310 E 14TH St
Suite 219
New York, NY 10003-4201
Phone (212) 505-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140131001526 NY Practitioner - Optometry 8325277981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10 Medical Plaza
Glen Cove, NY 11542-2101
Phone (516) 674-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008052NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Nov 6, 2021 Accepting new patients
Wilson Ko, M.D., F.a.C.S., P.C. CurrentSince Aug 1, 2018 Accepting new patients

Locations

13625 Maple Ave
Ste 202
Flushing, NY 11355
Phone (718) 358-5900

4 Medical Plz
Glen Cove, NY 11542
Phone (516) 674-0500

128 Mott St
Ste 408
New York, NY 10013
Phone (212) 732-0073

210 E 64th St
New York, NY 10065
Phone (212) 434-4312

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: jlo29058@northwell.direct-ci.com

Organizations & group practices 2

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1700228426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST",
            "address_2": "SUITE 219",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034201",
            "telephone_number": "212-505-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST",
            "address_2": "SUITE 219",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034201",
            "telephone_number": "212-505-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.