Individual provider Active NPI

Jessica Dixon Heinke, O.D.

  • Optometrist
  • Woodstock, IL
National Provider Identifier
1720089865
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009519 Issued in IL
Practice address
233 Washington St
Woodstock, IL 60098-3399
Phone
(815) 338-0674
Fax
(815) 338-6139
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3133-035 WI
Optometrist 152W00000X 3133-035 WI
Pediatric Optometrist 152WP0200X 046-009519 IL
Pediatric Optometrist 152WP0200X 3133-035 WI
Optometrist 152W00000X 046-009519 IL Primary
Corneal and Contact Management Optometrist 152WC0802X 046-009519 IL

Addresses

Primary practice location

233 Washington St
Woodstock, IL 60098-3399

Mailing address

233 Washington St
Woodstock, IL 60098-3399
Phone (815) 338-0674

Other practice location 1

835 Geneva Pkwy N Ste 3
Lake Geneva, WI 53147-5700
Phone (262) 248-4878

Other identifiers 2

IdentifierTypeStateIssuer
5632090OtherILIL BCBS
7333267OtherILAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040220000795 IL Practitioner - Optometry 4688569031 Reassigns benefits to 1 organization
I20090701000369 WI Practitioner - Optometry 4688569031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Care of Algonquin, LTD.Group PAC ID 0547155962, 3 clinicians
Family Eye Care of Lake Geneva S.C.Group PAC ID 9830240944, 3 clinicians

Practice addresses (Care Compare)

233 Washington St
Woodstock, IL 60098-3399

835 Geneva Pkwy N
Suite 3
Lake Geneva, WI 53147-5700
Phone (262) 248-4878

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009519ILMDOptometrist
3133-035WIMDOptometrist
1173SCMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Care of Lake Geneva, S.C. Optometrist CurrentSince May 6, 2009 Accepting new patients

Locations

835 Geneva Pkwy N
Ste 3
Lake Geneva, WI 53147
Phone (262) 248-3800

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1720089865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983399",
            "telephone_number": "815-338-0674",
            "fax_number": "815-338-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983399",
            "telephone_number": "815-338-0674",
            "fax_number": "815-338-6139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Geneva Pkwy N Ste 3",
            "address_purpose": "LOCATION",
            "city": "Lake Geneva",
            "state": "WI",
            "postal_code": "531475700",
            "country_code": "US",
            "telephone_number": "262-248-4878",
            "fax_number": "262-248-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINKE",
        "first_name": "JESSICA",
        "middle_name": "DIXON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WI",
            "license": "3133-035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3133-035",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IL",
            "license": "046-009519",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WI",
            "license": "3133-035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009519",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046-009519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BCBS",
            "identifier": "5632090",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7333267",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.