Jacqlyn E Long, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008207 Issued in IL

Practice address

211 E Broadway
Alton, IL 62002-6220

Phone

(618) 462-9818

Fax

(314) 741-4947

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jacqlyn E Reinert Other name

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

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 2

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.

• Nu-Crown, LLC

  • Optometrist
  • Alton, IL
  • NPI 1295737294

  IL, MO, Optometrist

  Medicare reassignment Care Compare group NPD
• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411

  IL, Optometrist

  Medicare reassignment NPD
• Paige Hedgpath OD,PC

  • Optometrist
  • Jefferson City, MO
  • NPI 1962644732

  MO, Optometrist

  Medicare reassignment NPD
• Nu-Crown, LLC

  • Optometrist
  • Ballwin, MO
  • NPI 1710045810
  Care Compare group
• Nucrown, LLC

  • Optometrist
  • Bridgeton, MO
  • NPI 1730586629
  Care Compare group
• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1033261904
  NPD
• Nucrown,Inc.

  • Optometrist
  • St. Charles, MO
  • NPI 1114337102
  NPD
• Paige Hedgpath Odpc

  • Optometrist
  • Columbia, MO
  • NPI 1669530887
  NPD
• Pearle Vision Inc

  • Eyewear Supplier
  • Fairview Heights, IL
  • NPI 1982744033
  NPD (past)
• Altenbernd Family Eye Care, LLC

  • Corneal and Contact Management Optometrist
  • Saint Louis, MO
  • NPI 1952725210
  NPD (past)
• Luxottica Retail North America Inc

  • Optometrist
  • Mason, OH
  • NPI 1891832580
  NPD (past)

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nucrown, LLC 22 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1992866057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242088",
            "telephone_number": "314-721-2720",
            "fax_number": "314-725-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACQLYN",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02865",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0854830001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318096041",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQLYN",
            "last_name": "REINERT",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carol Logan
• Kenya Logan
• Stephanie Logan
• Gillian K Long, FNP-C
• Jacob Long
• Abigail Marie Lorentz
• John Gregory Lorsbach, PT
• Sara Ann Lorsbach, PT
• Michelle Marie Lovsey, APRN, AG CNS-BC
• Ellyn E Lowry, MS, LCPC

• All providers in Alton, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.