Individual provider Active NPI

Jay Chris Christensen, O.D.

  • Optometrist
  • Harlan, IA
National Provider Identifier
1992705404
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02008 Issued in IA
Practice address
620 Market St
Harlan, IA 51537-1412
Phone
(712) 755-2020
Fax
(712) 755-9400
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02008 IA Primary

Addresses

Primary practice location

620 Market St
Harlan, IA 51537-1412

Mailing address

PO Box 712
Harlan, IA 51537-0712
Phone (712) 755-2020

Other identifiers 2

IdentifierTypeStateIssuer
I8256MedicaidIA
0292748MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20101209001105 IA Practitioner - Optometry 6709868193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harlan Eye Care PCGroup PAC ID 5193122729, 2 clinicians

Practice addresses (Care Compare)

712 Durant St
Harlan, IA 51537-1621
Phone (712) 755-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02008IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harlan Eye Care PC Optometrist CurrentSince Oct 11, 2021 Accepting new patients
Family Eye Care PC Optometrist PastSince Aug 11, 1997 Accepting new patients
Family Eye Care of Ida Grove PC Optometrist PastSince Aug 21, 2015 Accepting new patients

Locations

620 Market St
Harlan, IA 51537
Phone (712) 755-2020

712 Durant St
Harlan, IA 51537
Phone (712) 755-2020

Interoperability endpoints

  • Direct secure messaging: jchristensen129297@uihcdirect.org

Organizations & group practices 3

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1992705404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 712",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515370712",
            "telephone_number": "712-755-2020",
            "fax_number": "712-755-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MARKET ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371412",
            "telephone_number": "712-755-2020",
            "fax_number": "712-755-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "JAY",
        "middle_name": "CHRIS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "I8256",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292748",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

Verify at the official NPI Registry.