DR. JACLYN CHARBONNEAU (OD) – Optometrist, NPI 1306739016

DR. JACLYN CHARBONNEAU (OD) is a healthcare provider. based in Ladera ranch, California. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 35973 (CA). The NPI Number for DR. JACLYN CHARBONNEAU (OD) is 1306739016

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
DR. JACLYN CHARBONNEAU (OD)
NPI
1306739016
Phone
(949) 683-2165
Address
6 SHELTON CT
Enumeration Date
31 May 2025
Last Update Date
31 May 2025

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
3232349137
Graduation Year
2025 (1 year ago)
PAC ID
9436660933
Group Practice PAC ID
9739075177
Professional Enrollment ID
I20250612002147
Address ID
CA900371307LO3916XBROA300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

3,909 OPTOMETRY in CA

Provider Addresses for DR. JACLYN CHARBONNEAU (OD)

  • 6 SHELTON CT

    LADERA RANCH, CA 926940743

    Phone: (949) 683-2165

    Type: Mailing

  • 5460 E LA PALMA AVE

    ANAHEIM, CA 928072023

    Phone: (714) 463-7500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250612002147IOptometryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92694)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739075177View full group profile
NameSpecialtyState
-CA
O P T O M E T R YCA
O P T O M E T R YCA
O P T O M E T R YCA
O P T O M E T R YCA
O P T O M E T R YCA
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YCA
O P T O M E T R YCA
Physician AssistantCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. JACLYN CHARBONNEAU (OD)?
DR. JACLYN CHARBONNEAU (OD) — NPI 1306739016 — is the standard way to identify this listing.
Is DR. JACLYN CHARBONNEAU (OD) listed as active for patients and plans?
The listing shows DR. JACLYN CHARBONNEAU (OD) as active in the NPI system.
What is DR. JACLYN CHARBONNEAU (OD)'s specialty?
The listing groups DR. JACLYN CHARBONNEAU (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What area does DR. JACLYN CHARBONNEAU (OD) serve?
DR. JACLYN CHARBONNEAU (OD)'s listing highlights Ladera Ranch, California; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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