Edem Mardona Jongue

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011877 Issued in IL

Practice address

3241 S Michigan Ave Ste 1
Chicago, IL 60616-3878

Phone

(312) 225-6200

Fax

(312) 949-7616

NPI assigned

May 15, 2024

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 IL

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

Illinois College of Optometry at Chicago, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J a K Enterprises IncGroup PAC ID 3173519014, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 29)

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• J a K Enterprises Inc

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1508856923

  Optometrist

  Medicare reassignment Care Compare group NPD
• Charles S Ovitsky PC

  • Optometrist
  • Chicago, IL
  • NPI 1568647220
  Medicare reassignment NPD
• Illinois College of Optometry

  • Optometrist
  • Chicago, IL
  • NPI 1285612390
  Medicare reassignment NPD
• The Chicago Lighthouse for People Who Are Blind Or Visually Impaired

  • Low Vision Rehabilitation Optometrist
  • Chicago, IL
  • NPI 1043326309
  Medicare reassignment NPD
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Litchfield, IL
  • NPI 1205663499

  Optometrist

  NPD
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Pontiac, IL
  • NPI 1255617924

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Peoria, IL
  • NPI 1376581611

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Moline, IL
  • NPI 1790723542

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1730938325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163878",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163878",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGUE",
        "first_name": "EDEM",
        "middle_name": "MARDONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "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": "IL",
            "license": "046011877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Verbie Mae Jones, LCSW
• Vivian Jones
• Whitney Jones, MD
• William Jones
• Angela Jonesacosta
• Bryan David Jonke
• Virgilio Ilagan Jonson, MD
• Lina M Jonynas, D.D.S.
• Dillon Joo
• Justin H Joo, DPT

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.