DR. JEANETTE JEZICK OD
NPI 1922019918
Optometrist in Gales Ferry, CT

NPI Status: Active since August 11, 2006

Contact Information

1663 ROUTE 12
GALES FERRY, CT
ZIP 06335
Phone: (860) 464-1040
Fax: (860) 464-1044

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  • Individual
  • Female
  • Years of Experience 33
  • Optometrist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • CLIA Number: 07D2061740
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-02-2025

About JEANETTE JEZICK

This page provides the complete NPI Profile along with additional information for Jeanette Jezick, a provider established in Gales Ferry, Connecticut with a medical specialization in Optometrist and more than 33 years of experience. She graduated from New England College Of Optometry in 1993. The healthcare provider is registered in the NPI registry with number 1922019918 assigned on August 2006. The practitioner's primary taxonomy code is 152W00000X with license number 002353 (CT). The provider is registered as an individual and her NPI record was last updated 16 years ago.

NPI
1922019918
Provider Name
DR. JEANETTE JEZICK OD
Gender
Female
Entity Type
Individual
Location Address
1663 ROUTE 12 GALES FERRY, CT 06335
Location Phone
(860) 464-1040
Location Fax
(860) 464-1044
Mailing Address
1663 ROUTE 12 PO BOX 421 GALES FERRY, CT 06335
Mailing Phone
(860) 464-1040
Mailing Fax
(860) 464-1044
Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Graduation Year
1993
Is Sole Proprietor?
Yes
Enumeration Date
08-11-2006
Last Update Date
08-11-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Optometrist

Taxonomy Code
152W00000X
Type
Eye and Vision Services Providers
License No.
002353
License State
CT
Taxonomy Description
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueCross B07S HSA - EPO
  • BlueCross B15S $0 virtual care from Teladoc Health � - EPO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
U46251MEDICARE UPIN (02)CT 
410000975MEDICARE ID-TYPE UNSPECIFIED (04)CT 
004132429MEDICAID (05)CT 

Medicare Participation & PECOS Enrollment Status

Jeanette Jezick is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jeanette Jezick is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7416035654

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20080429000189

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient complete exam of visual system

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

This service was performed 104 times for 104 patients

Exam of visual field with extended testing

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

This service was performed 79 times for 76 patients

Imaging of optic nerve

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

This service was performed 59 times for 57 patients

Imaging of retina

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

This service was performed 20 times for 19 patients

New patient complete exam of visual system

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

This service was performed 20 times for 20 patients

Photography of the retina

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

This service was performed 103 times for 102 patients

Ultrasound scan of cornea to determine thickness

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

This service was performed 27 times for 27 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $34.71 for a new patient copayment and $18.88 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 06335 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $138.84
  • Minimum New Patient Price $60.82
  • Maximum New Patient Price $183.1
  • Average New Patient Copayment $34.71
  • Minimum New Patient Copayment $15.2
  • Maximum New Patient Copayment $45.77

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $75.55
  • Minimum Established Patient Price $19.76
  • Maximum Established Patient Price $149.26
  • Average Established Patient Copayment $18.88
  • Minimum Established Patient Copayment $4.94
  • Maximum Established Patient Copayment $37.31

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
07D2061740
Facility Type
Physician Office
Certificate Effective Date
July 03, 2023
Certificate Expiration Date
July 02, 2025
Laboratory Director
JEANETTE JEZICK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Jeanette Jezick to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1922019918
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2942011892
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 4 + 2 + 0 + 1 + 1 + 8 + 9 + 2 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1922019918 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1134239718DR. ROBERT CHARLES BARNETT D.C.
Individual
Chiropractor (Sports Physician)1663 ROUTE 12
GALES FERRY, CT 06335
(860) 464-0036
1144556192DR. JEANETTE JEZICK OD., LLC
Organization
Optometrist1663 ROUTE 12
GALES FERRY, CT 06335
(860) 464-1040
1811767395PATH 2 SELF PERFORMANCE PHYSICAL THERAPY LLC
Organization
Clinic/Center (Physical Therapy)1663 ROUTE 12
GALES FERRY, CT 06335
(860) 908-6139
1215789649 JONATHAN ZANE LMSW
Individual
Social Worker1663 ROUTE 12
GALES FERRY, CT 06335
(860) 415-6049
1598584088 ABBEY BALDARELLI
Individual
Social Worker1663 ROUTE 12
GALES FERRY, CT 06335
(860) 462-4424

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922019918, enumerated in the NPI registry as an "individual" on August 11, 2006

The provider is located at 1663 Route 12 Gales Ferry, Ct 06335 and the phone number is (860) 464-1040

The provider's speciality is Optometrist with taxonomy code 152W00000X

The provider has more than 33 years of experience. She graduated from New England College Of Optometry in 1993.

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Medicare and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Medicare beneficiaries should expect a typical cost of $138.84 with an average copayment of $34.71 for new patient appointments. Established patients should expect a typical charge of $75.55 and an average copayment of 18.88. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Established patient complete exam of visual system, Exam of visual field with extended testing, Imaging of optic nerve, Imaging of retina, New patient complete exam of visual system, Photography of the retina and Ultrasound scan of cornea to determine thickness.

The provider's CLIA number is 07D2061740 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on August 11, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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