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DR. JESSICA LYNN BROODRYK OD
NPI 1588289474
Optometrist in Berkeley, CA

Active since June 16, 2020PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
200 MINOR HALL, BERKELEY, CA 94720(510) 642-2020 Get Directions Write a Review

NPPES record last updated: June 16, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jessica Lynn Broodryk Od NPPES

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

DR. JESSICA LYNN BROODRYK OD (NPI 1588289474) is an individual optometrist in Berkeley, California, licensed in Missouri (2020014783) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of University Of Missouri St Louis - School Of Optometry (2020).

NPPES Registry Identity

NPI1588289474
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. JESSICA LYNN BROODRYKCredential: OD
Location Address200 MINOR HALLBerkeley, CA 94720-0001
Mailing Address200 Minor HallBerkeley, CA 94720-0001
Phone(510) 642-2020
Sole ProprietorNo
Medical School CMSUniversity Of Missouri St Louis - School Of OptometryGraduated 2020
Enumeration DateJune 16, 2020
NPPES CertifiedJune 16, 2020
✔ NPI 1588289474 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 MO · 2020014783
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.
200 MINOR HALL, Berkeley, CA 94720
Open in Google Maps ↗

Other Names 1

Former Name (1)Jessica Lynn Blomenkamp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health 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. Jessica Lynn Broodryk 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 ID1052722105
PECOS Enrollment IDI20210806001191
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

4

Medicare enrollment records show Jessica Broodryk reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Envision Eye Specialists PC
1,722 mi
Ophthalmology
1011 BOWLES AVE, SUITE 200
Fenton, MO 63026
  • Reassigned Medicare billing, Missouri enrollment
  • 7 clinicians in this Medicare group
NPI 1205072360 (636) 717-1700
St Louis Society For The Blind
1,728 mi
Low Vision Rehabilitation
8770 MANCHESTER RD
Saint Louis, MO 63144
  • Reassigned Medicare billing, Missouri enrollment
  • 6 clinicians in this Medicare group
NPI 1942661186 (314) 968-9000
Curators Of The University Of Missouri
1,729 mi
Optometrist
7840 NATURAL BRIDGE BLVD, PATIENT CARE CENTER
Saint Louis, MO 63121
  • Reassigned Medicare billing, Missouri enrollment
  • Also billed through NPI 1922190198 (Missouri)
  • 38 clinicians in this Medicare group
NPI 1679664718 (314) 516-5131
Affinia Healthcare
1,734 mi
Federally Qualified Health Center (FQHC)
3930 S BROADWAY
Saint Louis, MO 63118
  • Reassigned Medicare billing, Missouri enrollment
  • 85 clinicians in this Medicare group
NPI 1013925890 (314) 577-6232

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 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.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
18 services18 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94720 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
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

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.

DR. CARL H. JACOBSEN O.D.
Optometrist
200 MINOR HALL, UC BERKELEY
BERKELEY, CA 94720
Alameda County (510) 643-9826
DR. JOHN CORZINE O.D.
Optometrist (Corneal and Contact Management)
200 MINOR HALL, UNIVERSITY OF CALIFORNIA
BERKELEY, CA 94720
Alameda County (510) 643-2793
DR. JOYCE CHI YAN YU O.D.
Optometrist
200 MINOR HALL
BERKELEY, CA 94720
Alameda County (510) 642-2020
JEFFREY KAMO OD
Optometrist (Corneal and Contact Management)
200 MINOR HALL
BERKELEY, CA 94720
Alameda County (510) 642-2020
DR. VALERY MEDINA OD
Optometrist
200 MINOR HALL
BERKELEY, CA 94720
Alameda County (510) 642-6123
DR. KAYLE RAE EDWARDS OD
Optometrist
200 MINOR HALL
BERKELEY, CA 94720
Alameda County (510) 642-2020
DR. SARA FRANE O.D.
Optometrist
200 MINOR HALL, UNIVERSITY OF CALIFORNIA, BERKELEY
BERKELEY, CA 94720
Alameda County (510) 642-2020
YUNG FEN CHEN OD
Optometrist
200 MINOR HALL
BERKELEY, CA 94720
Alameda County (510) 642-2020

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 Jessica Broodryk's NPI number?

The NPI number for Jessica Broodryk is 1588289474. It was assigned to this individual provider in the NPPES registry on June 16, 2020. The provider is also known as Jessica Lynn Blomenkamp.

Where is Jessica Broodryk located?

Jessica Broodryk practices at 200 Minor Hall, Berkeley, CA 94720. The listed phone number is (510) 642-2020.

What is Jessica Broodryk's specialty?

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

Is Jessica Broodryk enrolled in Medicare?

Yes. Jessica Broodryk 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 Jessica Broodryk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Broodryk reassigns Medicare benefits to 4 organizations: Envision Eye Specialists PC (Fenton, MO), St Louis Society For The Blind (Saint Louis, MO), Curators Of The University Of Missouri (Saint Louis, MO) and Affinia Healthcare (Saint Louis, MO). 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 Jessica Broodryk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Broodryk accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 17 other insurers list Jessica Broodryk 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 Jessica Broodryk was last updated on June 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.