Duane L Jackson Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00002039 Issued in WA

Practice address

28815 Pacific Hwy S Ste 2
Federal Way, WA 98003-3876

Phone

(253) 941-7074

Fax

(253) 941-5079

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Pacific University - College of Optometry, 1987

Medicare assignment

May accept Medicare assignment

Group practices

DRS Jackson and Lee IncGroup PAC ID 4880771724, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• DRS Jackson & Lee, Inc

  • Optometrist
  • Federal Way, WA
  • NPI 1194883017
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1962628073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28815 PACIFIC HWY S STE 2",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033876",
            "telephone_number": "253-941-7074",
            "fax_number": "253-941-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28815 PACIFIC HWY S STE 2",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033876",
            "telephone_number": "253-941-7074",
            "fax_number": "253-941-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DUANE",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00002039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "120065",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015139",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J.D.Martini, DMD, PS
• Mona Jaber
• Thomas E. Jacka, D.D.S.
• Nina Jackson-King
• Kyrsten Savannah Jackson-Kinney
• Lisa Marie Jackson
• Mara Jacobo Amezquita, DPT
• Ruth Jacobs
• Yonaton A Jacobs, ARNP
• Bret H Jacobson, DDS

• Optometrist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.