Individual provider Active NPI

Jessica Pierce Gage, O.D.

  • Optometrist
  • Nantucket, MA
National Provider Identifier
1962495689
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP-4513-TP Issued in MA
Practice address
13 Old South Rd
Nantucket, MA 02554-6065
Phone
(508) 228-0844
Fax
(508) 228-0491
NPI assigned
Aug 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP-4513-TP MA Primary

Addresses

Primary practice location

13 Old South Rd
Nantucket, MA 02554-6065

Mailing address

13 Old South Rd
Nantucket, MA 02554-6065
Phone (508) 228-0844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140110001066 MA Practitioner - Optometry 9335377761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP-4513-TPMAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ack Eye, PC Optometrist CurrentSince Nov 2, 2013 Accepting new patients

Locations

13 Old South Rd
Nantucket, MA 02554
Phone (508) 228-0844

64 Old South Rd
Nantucket, MA 02554
Phone (508) 228-0844

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": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1962495689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 OLD SOUTH RD",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025546065",
            "telephone_number": "508-228-0844",
            "fax_number": "508-228-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 OLD SOUTH RD",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025546065",
            "telephone_number": "508-228-0844",
            "fax_number": "508-228-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGE",
        "first_name": "JESSICA",
        "middle_name": "PIERCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-28",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OP-4513-TP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nantucket, MA

Sources for this page

Verify at the official NPI Registry.