Jillian Rose Peabody

Primary specialty

OptometristTaxonomy code 152W00000X

License

1085 Issued in NH

Practice address

1245 Elm St
Manchester, NH 03101-1308

Phone

(603) 626-9523

NPI assigned

Jun 27, 2023

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 names 1

• Miss Jillian Rose Kossak Former name

Medicare fee-for-service enrollment

Enrolled in NH

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amoskeag HealthGroup PAC ID 8527038421, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/28516/brand/1/csg/1/fhir/r4
• Direct secure messaging: jillian.peabody.1@28516.direct.athenahealth.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.

• Amoskeag Health

  • Federally Qualified Health Center (FQHC)
  • Manchester, NH
  • NPI 1083617013
  Medicare reassignment Care Compare group NPD
• Amoskeag Health

  • Federally Qualified Health Center (FQHC)
  • Manchester, NH
  • NPI 1225625643
  NPD
• Amoskeag Health

  • Federally Qualified Health Center (FQHC)
  • Manchester, NH
  • NPI 1699012492
  NPD
• Amoskeag Health

  • Developmental Disabilities Clinic/Center
  • Manchester, NH
  • NPI 1457744898
  NPD (past)

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1891471413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 HAWTHORNE DR APT 408",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031107074",
            "telephone_number": "603-714-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 ELM ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011308",
            "telephone_number": "603-626-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEABODY",
        "first_name": "JILLIAN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "KOSSAK",
            "middle_name": "ROSE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Thompson DDS PA
• Angela Paul
• Matthew Payne
• Russell Berry Payne, APRN
• Elizabeth A Payonk, MD
• Christie Odend'Hal Pearce, M.S.ED
• Rebecca Helene Pearce, LICSW
• Pearl Street Healthcare Center LLC
• Pearla Homes LLC
• Pearle Vision Inc

• Optometrist in Manchester, NH
• Providers in Manchester, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.