Individual provider Active NPI

Jesse Andrew Jones, O.D.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1922153394
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001670 Issued in PA
Practice address
4189 Ridge Ave
Philadelphia, PA 19129-1545
Phone
(215) 844-2406
NPI assigned
Jan 24, 2007
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG001670 PA Primary

Addresses

Primary practice location

4189 Ridge Ave
Philadelphia, PA 19129-1545

Mailing address

303 Penbree Ter
Bala Cynwyd, PA 19004-2333
Phone (215) 527-6605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20051104000269 PA Practitioner - Optometry 1557389913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4189 Ridge Ave
Philadelphia, PA 19129-1545
Phone (215) 844-2406

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001670PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
East Falls Eye Associates, PC CurrentSince Nov 1, 2005 Accepting new patients
Karen J Solofsky, O.D. LLC Optometrist PastSince Nov 1, 2005 Accepting new patients

Locations

4189 Ridge Ave
Philadelphia, PA 19129
Phone (215) 527-6605

4189 Ridge Ave
Fl 3
Philadelphia, PA 19129

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1922153394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PENBREE TER",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042333",
            "telephone_number": "215-527-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4189 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291545",
            "telephone_number": "215-844-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JESSE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.