Jennifer K Bass, OD
Individual provider Active NPI Optometrist · Mt Vernon, IL
NPI 1922009950 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1922009950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- Practice address
- 112 S 42ND St
Mt Vernon, IL 62864 - Phone
- (618) 244-0508
- Fax
- (618) 244-0646
- NPI assigned
- Aug 1, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- J Bass LTD
Practice addresses (Care Compare)
112 S 42ND St
Mount Vernon, IL 62864-2243
Phone (618) 244-0508
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 92 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040901000782 | IL | Practitioner - Optometry | 7012982069 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-009445 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J Bass LTD | Optometrist | Current |
Accepting new patients |
| Percav, Inc | Optometrist | Past | Accepting new patients |
Locations
112 S 42nd St
Mount Vernon, IL 62864
Phone (618) 244-0508
Interoperability endpoints
- direct@provisioneyecaremountvernonil.compulinkdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Yes |
Addresses
Primary practice location
112 S 42ND St
Mt Vernon, IL 62864
Mailing address
112 S 42ND St
Mt Vernon, IL 62864
Phone (618) 244-0508
Other providers in Mt Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.