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DR. JACQUELYN GAYLE SHORT O.D.
NPI 1588072003
Optometrist in Archbold, OH

Active since July 28, 2014PECOS EnrolledAccepts Medicare Assignment
1001 S DEFIANCE ST, ARCHBOLD, OH 43502(419) 445-5436(419) 446-4818 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 12, 2026, Oct 1, 2021, Jan 25, 2021 and 2 more (5 updates tracked since 2017).

About Dr. Jacquelyn Gayle Short O.d. NPPES

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

DR. JACQUELYN GAYLE SHORT O.D. (NPI 1588072003) is an individual optometrist in Archbold, Ohio, licensed in Ohio (7000) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Defiance, and is a graduate of Southern College Of Optometry (2014).

NPPES Registry Identity

NPI1588072003
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. JACQUELYN GAYLE SHORTCredential: O.D.
Location Address1001 S DEFIANCE STArchbold, OH 43502-1617
Mailing AddressPo Box 38Archbold, OH 43502-0038 · (419) 445-5436 · Fax (419) 446-4818
Phone(419) 445-5436
Fax(419) 446-4818
Sole ProprietorNo
Medical School CMSSouthern College Of OptometryGraduated 2014
Enumeration DateJuly 28, 2014
Last NPPES UpdateMarch 12, 20265 updates tracked since enumeration
NPPES CertifiedMarch 12, 2026
✔ NPI 1588072003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in OH · 7000
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.
Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 7000 (OH)
Also ListedOptometrist · PediatricsTaxonomy 152WP0200X · License 7000 (OH)
1001 S DEFIANCE ST, Archbold, OH 43502
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Secondary Practice Location 1

Location 1800 N Clinton St Ste DDefiance, OH 43512-4611 · Phone (419) 782-1901 · Fax (419) 782-2200

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacquelyn Gayle Short 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 ID4880919430
PECOS Enrollment IDI20211007002972
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jacquelyn Short reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kings Vision Center
Same address
Optometrist
1001 S DEFIANCE ST
Archbold, OH 43502
  • Reassigned Medicare billing, Ohio enrollment
NPI 1457203614 (419) 445-5436
Defiance Optometric Group Inc
15 mi
Optometrist
800 N CLINTON ST, SUITE D
Defiance, OH 43512
  • Reassigned Medicare billing, Ohio enrollment
  • 3 clinicians in this Medicare group
NPI 1255443792 (419) 782-1901

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
2,099 services16 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.
129 services129 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
88 services65 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
74 services59 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
63 services54 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
27 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43502 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 2

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

MR. CHRISTIAN A KING O.D.
Optometrist
1001 S DEFIANCE ST, 1001 SOUTH DEFIANCE ST
ARCHBOLD, OH 43502
Fulton County (419) 445-5436
KINGS VISION CENTER
Optometrist
1001 S DEFIANCE ST
ARCHBOLD, OH 43502
Fulton County (419) 445-5436

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 Jacquelyn Short's NPI number?

The NPI number for Jacquelyn Short is 1588072003. It was assigned to this individual provider in the NPPES registry on July 28, 2014.

Where is Jacquelyn Short located?

Jacquelyn Short practices at 1001 S Defiance St, Archbold, OH 43502. The listed phone number is (419) 445-5436.

What is Jacquelyn Short's specialty?

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

Is Jacquelyn Short enrolled in Medicare?

Yes. Jacquelyn Short 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.

Which organizations bill Medicare for Jacquelyn Short's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Short reassigns Medicare benefits to 2 organizations: Kings Vision Center (Archbold, OH) and Defiance Optometric Group Inc (Defiance, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacquelyn Short's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacquelyn Short accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 11 other insurers list Jacquelyn Short 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 Jacquelyn Short was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.