Individual provider Active NPI

Jessica King, O.D.

  • Optometrist
  • South Windsor, CT
National Provider Identifier
1992157333
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2993 Issued in CT
Practice address
93 Evergreen Way
South Windsor, CT 06074-6975
Phone
(860) 644-4362
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2993 CT Primary

Addresses

Primary practice location

93 Evergreen Way
South Windsor, CT 06074-6975

Mailing address

184 Market Dr
Athol, MA 01331-9829
Phone (978) 939-3128

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
I20180907000219 MA Practitioner - Optometry 4385924836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planeye, LLCGroup PAC ID 0244645554, 3 clinicians

Practice addresses (Care Compare)

184 Market Dr
Athol, MA 01331-9829
Phone (978) 939-3128

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
100
Improvement activities
40
Cost
25.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5276MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Planeye, LLC CurrentSince Nov 18, 2021 Accepting new patients

Locations

184 Market Dr
Athol, MA 01331
Phone (978) 248-9834

33 Riddell St
Greenfield, MA 01301
Phone (413) 772-0853

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1992157333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 MARKET DR",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013319829",
            "telephone_number": "978-939-3128",
            "fax_number": "978-650-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 EVERGREEN WAY",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060746975",
            "telephone_number": "860-644-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JESSICA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.