Kaylyn R Jackman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

991 Issued in NE

Practice address

1710 S 70TH St
Lincoln, NE 68506-1676

Phone

(402) 484-9000

Fax

(402) 483-4223

NPI assigned

Jul 7, 2005

Sex

Female

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Surgical Associates LLCGroup PAC ID 4082695721, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.69 of 100Reported as group

Quality

100

Improvement activities

40

Cost

62.3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Interoperability endpoints

• Direct secure messaging: kjackman@esane.intellechartdirect.net

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.

• Eye Surgical Associates, LLC

  • Ophthalmology Physician
  • Lincoln, NE
  • NPI 1417952995
  Medicare reassignment Care Compare group
• Sutton Skin and Eye Clinic PC

  dba Sutton Dermatology and Aesthetics

  • Dermatology Physician
  • Lincoln, NE
  • NPI 1881690261
  NPD (past)
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1871590778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 S 70TH ST",
            "address_2": "PO BOX 6068",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061676",
            "telephone_number": "402-484-9000",
            "fax_number": "402-483-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061676",
            "telephone_number": "402-484-9000",
            "fax_number": "402-483-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "KAYLYN",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025619800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "06909",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410039754",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjackman@esane.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "1710 S 70th St",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685061676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• J Sloan Counseling Services LLC
• Kelsey Marie Jaacks, RN
• Haneen Jabbar
• Hasan Jabbar
• Raneen S Jabbar
• Sharon Denise Jackson-George
• Demetria Letrice Jackson-Jeter, DEMETRIA JACKSON
• Ajala Jackson
• Alyson Marie Jackson
• Anthony Jackson

• Optometrist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.