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DR. JACK M ELIZARES O.D.
NPI 1295715712
Optometrist in Clearlake, CA

Active since January 19, 2006PECOS EnrolledAccepts Medicare Assignment
3610 OLD HIGHWAY 53, CLEARLAKE, CA 95422(707) 994-8641(707) 994-5858 Get Directions Write a Review

NPPES record last updated: March 9, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jack M Elizares O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK M ELIZARES O.D. (NPI 1295715712) is an individual optometrist in Clearlake, California, licensed in California (6646) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California - School Of Optometry (1979).

NPPES Registry Identity

NPI1295715712
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JACK M ELIZARESCredential: O.D.
Location Address3610 OLD HIGHWAY 53Clearlake, CA 95422-9253
Mailing Address3610 Old Highway 53Clearlake, CA 95422-9253 · (707) 994-8641 · Fax (707) 994-5858
Phone(707) 994-8641
Fax(707) 994-5858
Sole ProprietorYes
Medical School CMSUniversity Of California - School Of OptometryGraduated 1979
Enumeration DateJanuary 19, 2006
Last NPPES UpdateMarch 9, 2009
✔ NPI 1295715712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 6646
Definition
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.
3610 OLD HIGHWAY 53, Clearlake, CA 95422
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Other Identifiers 4

Medicare NSC0611210001CA
Medicare UPINT10384CA
MedicaidSD0066460CA
Medicare PINSD0066460CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack M Elizares O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537283023
PECOS Enrollment IDI20100907000424
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
45 services45 patients
Established patient complete exam of visual system 92014
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.
19 services19 patients
New patient complete exam of visual system 92004
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.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95422 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Elizares's NPI number?

The NPI number for Jack Elizares is 1295715712. It was assigned to this individual provider in the NPPES registry on January 19, 2006.

Where is Jack Elizares located?

Jack Elizares practices at 3610 Old Highway 53, Clearlake, CA 95422. The listed phone number is (707) 994-8641.

What is Jack Elizares's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Jack Elizares enrolled in Medicare?

Yes. Jack Elizares is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Elizares accept?

Health plans from Providence Health Plan list Jack Elizares as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Elizares was last updated on March 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.