Individual provider Active NPI

Janet Marie Mint, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1902894777
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC001769 Issued in FL
Practice address
4131 Southside Blvd
Ste 203
Jacksonville, FL 32216-5478
Phone
(904) 646-9737
Fax
(904) 646-9783
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC001769 FL Primary

Addresses

Primary practice location

4131 Southside Blvd
Ste 203
Jacksonville, FL 32216-5478

Mailing address

4131 Southside Blvd
Ste 203
Jacksonville, FL 32216-5478
Phone (904) 646-9737

Other identifiers 2

IdentifierTypeStateIssuer
078616100MedicaidFL
FKC1DOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120517000561 FL Practitioner - Optometry 8325201916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4131 Soutside Blvd
Suite 203
Jacksonville, FL 32216-5478
Phone (904) 646-9737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC001769FLMDOptometrist
1769FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Janet M. Mint, O.D., PA Optometrist CurrentSince Jul 9, 1990 Accepting new patients

Locations

4131 Southside Blvd
Ste 203
Jacksonville, FL 32216
Phone (904) 646-9737

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1902894777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 SOUTHSIDE BLVD",
            "address_2": "STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165478",
            "telephone_number": "904-646-9737",
            "fax_number": "904-646-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SOUTHSIDE BLVD",
            "address_2": "STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165478",
            "telephone_number": "904-646-9737",
            "fax_number": "904-646-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINT",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078616100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "FKC1D",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.