Tiffani Jackson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0003415 Issued in CO

Practice address

Highway Junction 57, Route 9
Crownpoint, NM 87313

Phone

(505) 786-2593

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

Yes

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.

• Advanced Vision Care

  • Optometrist
  • Victoria, TX
  • NPI 1568608891
  Medicare reassignment Care Compare group NPD
• DHHS PHS Naihs Crownpoint Hospital

  • General Acute Care Hospital
  • Crownpoint, NM
  • NPI 1114960093

  TX

  Medicare reassignment NPD
• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment NPD
• Total Care PLLC

  • Ophthalmology Physician
  • El Paso, TX
  • NPI 1487285656

  Optometrist, TX

  Medicare reassignment NPD
• Pueblo Pintado Clinic

  • Clinic/Center
  • Cuba, NM
  • NPI 1023051133
  NPD
• Thoreau Clinic

  • Clinic/Center
  • Thoreau, NM
  • NPI 1679516702
  NPD
• Janet B Ogletree OD PA

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)

Specialty

Optometry

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Vision Care 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 20, 2018.

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1780161984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HIGHWAY JUNCTION 57, ROUTE 9",
            "city": "CROWNPOINT",
            "state": "NM",
            "postal_code": "87313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY JUNCTION 57, ROUTE 9",
            "city": "CROWNPOINT",
            "state": "NM",
            "postal_code": "87313",
            "telephone_number": "505-786-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIFFANI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Ferguson, RDH
• Raul Flores
• Halley Marie Friedeman, NP
• Eugene Guei, PHARM D
• Tania Hurlbutt, MD
• Pearl J. James, LADAC
• Caroline Jensen, PHARMD
• Kenneth A Joe, DINE' TRADITIONAL
• John J Johnson, M.D.
• Allen Eugene Jones, CPNP

• All providers in Crownpoint, NM
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.