Trichelle Mae Jackson, O.D.

Individual provider Active NPI Optometrist · Forest City, IA

NPI 1720347644 · NPPES record last updated Feb 22, 2013

Key facts

NPI
1720347644
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
002543 (IA)
Practice address
139 E K St
Forest City, IA 50436-1501
Phone
(641) 585-3590
Fax
(641) 585-4058
NPI assigned
May 12, 2012
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Donald W Furman PC (4 clinicians)

Practice addresses (Care Compare)

139 E K St
Forest City, IA 50436-1501
Phone (641) 585-3590

Merit-based Incentive Payment System (MIPS)

Final score
89.83 of 100 (group)
Quality
79.66
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120804000098 IA Practitioner - Optometry 6800042078 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Donald W. Furman, P.C. Optometrist Current Accepting new patients
Donald W. Furman, P.C. Optometrist Current
since Jun 18, 2012
Accepting new patients
Donald W. Furman, P.C. Optometrist Current
since Jun 18, 2012
Accepting new patients

Locations

90 Main Ave N
Britt, IA 50423
Phone (515) 843-3841

139 E K St
Forest City, IA 50436
Phone (641) 585-3590

45 State St
Garner, IA 50438
Phone (641) 843-3841

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002543 IA Yes

Addresses

Primary practice location

139 E K St
Forest City, IA 50436-1501

Mailing address

PO Box 410
Forest City, IA 50436-0410
Phone (641) 585-3590

Other providers in Forest City, IA

All providers in Forest City, IA · Optometrist in Iowa

Sources for this page

Verify at the official NPI Registry.