Jack Steven Daubert, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0055247 Issued in FL

Practice address

1050 SE Monterry Rd
Ste #104
Stuart, FL 34994-4512

Phone

(772) 283-2020

Fax

(772) 220-9582

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jack.daubert.p2@direct.drea.nextgenshare.com

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.

• Florida Vision Optique, Inc

  • Durable Medical Equipment & Medical Supplies
  • Port Saint Lucie, FL
  • NPI 1265856702
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1790784270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTERRY RD",
            "address_2": "STE #104",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-283-2020",
            "fax_number": "772-220-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SE MONTERRY RD",
            "address_2": "STE #104",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-283-2020",
            "fax_number": "772-220-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBERT",
        "first_name": "JACK",
        "middle_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0055247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "08501",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062348200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RETIRED RAILROAD",
            "identifier": "08501V",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RETIRED RAILROAD",
            "identifier": "08501U",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Danley, BS
• Sophia Thaihien Dao
• Giuliana Mailen Daosta
• Simonsen Darius
• Wendy Darragh
• William T Daugherty, M.D.
• Facundo Davaro
• William H Davenport, M.D.
• David Nehme PA
• David Pinzler DO PA

• Ophthalmology Physician in Stuart, FL
• Providers in Stuart, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.