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JACK ROULEAU OD
NPI 1467200972
Optometrist in Bloomington, IN

Active since May 09, 2024PECOS EnrolledAccepts Medicare Assignment
744 E 3RD ST, BLOOMINGTON, IN 47405(812) 855-8436(812) 855-1683 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 12, 2026, Jul 1, 2024, May 9, 2024 (3 updates tracked since 2024).

About Jack Rouleau Od NPPES

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

JACK ROULEAU OD (NPI 1467200972) is an individual optometrist in Bloomington, Indiana, licensed in Arizona (OPT-002807) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS and is a graduate of Indiana University - School Of Optometry (2024).

NPPES Registry Identity

NPI1467200972
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameJACK ROULEAUCredential: OD
Location Address744 E 3RD STBloomington, IN 47405-3603
Mailing Address744 E 3rd StBloomington, IN 47405-3603 · (812) 855-8436 · Fax (812) 855-1683
Phone(812) 855-8436
Fax(812) 855-1683
Sole ProprietorNo
Medical School CMSIndiana University - School Of OptometryGraduated 2024
Enumeration DateMay 9, 2024
Last NPPES UpdateJanuary 12, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2026
✔ NPI 1467200972 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 AZ · OPT-002807
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.
744 E 3RD ST, Bloomington, IN 47405
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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

Jack Rouleau Od 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 ID7810437704
PECOS Enrollment IDI20250825003493
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47405 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAH GIBERSON OD
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436
BRETT JOSEPH KING O.D.
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-1344
DR. TODD DAVID PEABODY O.D.
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436
CIARA KNAPP
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436
DR. KATIE SHULIST CONNOLLY O.D.
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436
DR. SIDNEY ALDRIAN REYNES MAGDAONG OD
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436
INDIANA UNIVERSITY
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436
DR. PETER S KOLLBAUM O.D.
Optometrist
744 E 3RD ST
BLOOMINGTON, IN 47405
Monroe County (812) 855-8436

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 Rouleau's NPI number?

The NPI number for Jack Rouleau is 1467200972. It was assigned to this individual provider in the NPPES registry on May 9, 2024.

Where is Jack Rouleau located?

Jack Rouleau practices at 744 E 3rd St, Bloomington, IN 47405. The listed phone number is (812) 855-8436.

What is Jack Rouleau's specialty?

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

Is Jack Rouleau enrolled in Medicare?

Yes. Jack Rouleau 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 Rouleau accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and CareSource and 1 other insurer list Jack Rouleau 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 Rouleau was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.