Jackson Roland Pond, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

811 Issued in SD

Practice address

606 20TH St S
Brookings, SD 57006-4671

Phone

(605) 627-1212

NPI assigned

Apr 12, 2024

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

Medicare fee-for-service enrollment

Enrolled in SD

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

CP Twitero, PCGroup PAC ID 9436178167, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• CP Twitero, PC

  • Optometrist
  • Brookings, SD
  • NPI 1770884025
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1801640370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 6TH ST APT 201",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062382",
            "telephone_number": "507-626-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 20TH ST S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570064671",
            "telephone_number": "605-627-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "JACKSON",
        "middle_name": "ROLAND",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Dawn Peterson, PA-C
• Sara Ruth Peterson, DPT
• Brian L Piearson, OD
• Pietz-Coats Optometry Inc
• Theresa Plut, MA
• Madelyn Rae Ponto, CNP
• Prairie View Medical, Prof. LLC
• Pro PT, Inc.
• Caitlin Proechel
• Prouty Brookings Dental, LLC

• Optometrist in Brookings, SD
• Providers in Brookings, SD by specialty
• Optometrist in South Dakota

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