Jacob Thomas Janecek, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

2877AT Issued in OR

Practice address

1865 NW 169TH PL
Beaverton, OR 97006-7310

Phone

(503) 533-8441

Fax

(503) 533-8403

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunset Eye Clinic LLCGroup PAC ID 3678624301, 6 clinicians

Sunset Vision Center LLCGroup PAC ID 9830242924, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sunset Eye Clinic LLC

  • Optometrist
  • Beaverton, OR
  • NPI 1174549364
  Medicare reassignment Care Compare group NPD
• Sunset Vision Center LLC

  • Optometrist
  • Hillsboro, OR
  • NPI 1104997659
  Medicare reassignment Care Compare group
• Sunset Vision Center

  • Optometrist
  • Cornelius, OR
  • NPI 1811918949
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1992741441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17430 NW SOLANO LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292239",
            "telephone_number": "503-533-8441",
            "fax_number": "503-533-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 NW 169TH PL",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067310",
            "telephone_number": "503-533-8441",
            "fax_number": "503-533-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANECEK",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "2877AT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2877AT",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "2877AT",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "2877AT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181435",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry James
• Mandy L James, PA-C
• Nicholas James, PHARMD
• Theresa James, PHARMD
• Jessica Janakes, L.M.T., C.A.
• Janet Kirkland PHD PC
• Janine M. Macdonald, D.C., P.C.
• Sarah Jansala
• Anna Janssen
• Molly Kay Jarvis

• Optometrist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.