Individual provider Active NPI

Jannice Truc-Anh Doan

  • Optometrist
  • Chicago, IL
National Provider Identifier
1780433375
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011873 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

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011873 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

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

Mailing address

3241 S Michigan Ave Ste 1
Chicago, IL 60616-3878
Phone (312) 225-6200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240805002290 IL Practitioner - Optometry 1658818968 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011873ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois College of Optometry Optometrist CurrentSince Jul 19, 2024 Accepting new patients

Locations

3241 S Michigan Ave
Ste 1
Chicago, IL 60616
Phone (312) 225-6200

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

Interoperability endpoints

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

Organizations & group practices 1

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": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1780433375",
    "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": "DOAN",
        "first_name": "JANNICE",
        "middle_name": "TRUC-ANH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011873",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.