Individual provider Active NPI

Jacqueline E Doerr, O.D.

  • Vision Therapy Optometrist
  • Rockville, MD
National Provider Identifier
1740335470
Registry record updated Mar 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
TA1720 Issued in MD
Practice address
3204 Tower Oaks Blvd Ste 450
Rockville, MD 20852-4382
Phone
(240) 669-6930
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X TA1720 MD Primary

Addresses

Primary practice location

3204 Tower Oaks Blvd Ste 450
Rockville, MD 20852-4382

Mailing address

9501 Byeforde Rd
Kensington, MD 20895-3602
Phone (301) 529-4170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20100216000596 DC Practitioner - Optometry 0244374163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuro-Vision Therapy Center LLCGroup PAC ID 9436559812, 3 clinicians

Practice addresses (Care Compare)

3204 Tower Oaks Blvd
Suite 450
Rockville, MD 20852-4250
Phone (240) 669-6930

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1720MDMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Optometrist Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 12, 2001 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 12, 2001 Accepting new patients
Neuro-Vision Therapy Center LLC Vision Therapy CurrentSince May 25, 2021 Accepting new patients

Locations

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

3204 Tower Oaks Blvd
Ste 450
Rockville, MD 20852
Phone (240) 669-6930

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24346/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jacqueline.doerr.1@24346.direct.athenahealth.com

Organizations & group practices 5

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678492800000",
    "number": "1740335470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 BYEFORDE RD",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208953602",
            "telephone_number": "301-529-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 TOWER OAKS BLVD STE 450",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524382",
            "telephone_number": "240-669-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERR",
        "first_name": "JACQUELINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2023-03-11",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MD",
            "license": "TA1720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.