JACKLYN LY OD
NPI 1902779465
Optometrist in Orlando, FL
About Jacklyn Ly Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKLYN LY OD (NPI 1902779465) is an individual optometrist in Orlando, Florida, licensed in Florida (OPC6845) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Jacklyn Ly 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.
Medicare Billing Reassignment
Medicare enrollment records show Jacklyn Ly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jacksonville, FL 32224
- Reassigned Medicare billing, Florida enrollment
- 110 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32817 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Jacklyn Ly's NPI number?
The NPI number for Jacklyn Ly is 1902779465. It was assigned to this individual provider in the NPPES registry on September 29, 2025.
Where is Jacklyn Ly located?
Jacklyn Ly practices at 11794 E Colonial Dr, Orlando, FL 32817. The listed phone number is (407) 904-4431.
What is Jacklyn Ly's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Jacklyn Ly enrolled in Medicare?
Yes. Jacklyn Ly 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 organization bills Medicare for Jacklyn Ly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacklyn Ly reassigns Medicare benefits to Aeg Florida Professional PLLC (Jacksonville, FL). The 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 Jacklyn Ly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacklyn Ly accept?
Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 15 other insurers list Jacklyn Ly 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 Jacklyn Ly was last updated on January 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Jacklyn Ly, OD · NPI 1902779465
Optometrist provider in Orlando, Florida. Individual provider, active in the CMS NPPES registry since September 29, 2025.
## Identity
- **NPI:** 1902779465 (Entity type: Individual)
- **Enumerated:** September 29, 2025
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** OPC6845 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 11794 E COLONIAL DR, Orlando, FL 32817-4626
- **Phone:** (407) 904-4431
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Aeg Florida Professional PLLC (NPI 1164156246, Jacksonville, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** January 20, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1902779465) · Data from the CMS NPPES public registry.