JASMINE LOPEZ (OD) – Optometrist, NPI 1063291201

JASMINE LOPEZ (OD) is a healthcare provider. based in Blue island, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046.011799 (IL). The NPI Number for JASMINE LOPEZ (OD) is 1063291201

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
JASMINE LOPEZ (OD)
NPI
1063291201
Phone
(708) 388-1228
Address
13114 Western Ave
Enumeration Date
26 September 2023
Last Update Date
26 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7083881228
Graduation Year
2023 (3 years ago)
PAC ID
5799135778
Group Practice PAC ID
6305985961
Professional Enrollment ID
I20240103002583
Address ID
IL604062440BL13114AVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for JASMINE LOPEZ (OD)

  • 13114 Western Ave

    Blue Island, IL 604062439

    Phone: (708) 388-1228

    Type: Location

  • 6430 E STATE ST

    ROCKFORD, IL 611082529

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-08-23 • Largest payer in this snapshot: Alcon Vision LLC ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alcon Vision LLC$24
View all Open Payments →|Open Payments Risk Radar →

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: 2024-01-03

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
I20240103002583IOptometryILTBD

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 60406)

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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: 6305985961View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

Is JASMINE LOPEZ (OD) listed with a National Provider Identifier?
Yes — JASMINE LOPEZ (OD) has NPI 1063291201 on file in the registry.
Would JASMINE LOPEZ (OD) appear as active to a payer?
You can treat JASMINE LOPEZ (OD) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to JASMINE LOPEZ (OD)?
JASMINE LOPEZ (OD)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Is JASMINE LOPEZ (OD) located near Blue Island?
JASMINE LOPEZ (OD) currently maps to Blue Island, Illinois in this extract.
Can I trust this NPI listing for JASMINE LOPEZ (OD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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