Daniel Mark Jackson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

960 Issued in NE

Practice address

713 N 114TH St
Omaha, NE 68154-1515

Phone

(402) 991-3131

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NE

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

Ohio State University - College of Optometry, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Definitive Vision LLCGroup PAC ID 4880870666, 4 clinicians

Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djackson87849@direct.nebraskamed.com

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.

• Definitive Vision LLC

  • Optometrist
  • Omaha, NE
  • NPI 1215231717
  Medicare reassignment Care Compare group NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment Care Compare group NPD
• Provision Eye Care LLC

  • Optometrist
  • Omaha, NE
  • NPI 1902256647
  NPD Authorized official
• Omegavision PC

  • Optometrist
  • Omaha, NE
  • NPI 1487736500
  NPD (past)
• See Vision Services, LLC

  • Optometrist
  • Omaha, NE
  • NPI 1235914268
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Nebraska Medical Center

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1972502391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 N 114TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541515",
            "telephone_number": "402-991-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 N 114TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541515",
            "telephone_number": "402-991-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37154",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025388500",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00393695",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHARE ADVANTAGE",
            "identifier": "904415",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025583800",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025388400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Jackson
• Courtney Meyer Jackson, APRN
• Curtis Allen Jackson, ATC
• Dainiane Jackson
• Damon E Jackson
• Darin E Jackson, MD
• Darnell Jackson Jr.
• Deja Jackson
• Delaney Kaitlyn Jackson
• Demetria D Jackson

• Optometrist in Omaha, NE
• Providers in Omaha, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.