JACQUELINE RITA DE JESSE (OD) – Optometrist, NPI 1164419115

JACQUELINE RITA DE JESSE (OD) is a healthcare provider. based in Brookhaven, Pennsylvania. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. OEGOO1547 (PA). The NPI Number for JACQUELINE RITA DE JESSE (OD) is 1164419115

Main info

Female
47 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE RITA DE JESSE (OD)
NPI
1164419115
Phone
(610) 872-8989
Address
4106 EDGMONT AVE
Enumeration Date
4 October 2005
Last Update Date
25 November 2008

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
5092751271
Professional Enrollment ID
I20050629000120
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JACQUELINE RITA DE JESSE (OD)

  • 4106, Edgmont Avenue, Brookhaven, Delaware County, Pennsylvania, 19015, United States

    BROOKHAVEN, PA 190152314

    Phone: (610) 872-8989

    Fax: (610) 872-5220

    Mailing address matches the actual address.

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: 2005-06-29

PECOS data refreshed: 2026-06-15

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
I20050629000120IOptometryPATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system8076$0
92012Established patient problem focused exam of visual system2215$0
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Insurance plans in this area (ZIP 19015)

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Reviews

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Frequently asked questions

What NPI should I save for JACQUELINE RITA DE JESSE (OD)?
Save NPI 1164419115 if you need a stable reference for JACQUELINE RITA DE JESSE (OD).
Is JACQUELINE RITA DE JESSE (OD) active in the national directory?
JACQUELINE RITA DE JESSE (OD)'s public NPI profile is in an active state.
What kind of provider is JACQUELINE RITA DE JESSE (OD)?
The page reflects Optometrist for JACQUELINE RITA DE JESSE (OD). Clinical services aligned with this taxonomy classification.
Where is JACQUELINE RITA DE JESSE (OD)'s primary listing?
We display Brookhaven, Pennsylvania because that is what the record indicates for JACQUELINE RITA DE JESSE (OD).
What if Brookhaven, Pennsylvania seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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