JACKLYN LY OD
NPI 1902779465
Optometrist in Orlando, FL

Q: 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.

Q: What is Jacklyn Ly's specialty?

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

Q: 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 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.

Active since September 29, 2025PECOS EnrolledAccepts Medicare Assignment

11794 E COLONIAL DR, ORLANDO, FL 32817(407) 904-4431 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 20, 2026, Nov 19, 2025 (2 updates tracked since 2025).

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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

NPI1902779465

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameJACKLYN LYCredential: OD

Location Address11794 E COLONIAL DROrlando, FL 32817-4626

Mailing Address11794 E Colonial DrOrlando, FL 32817-4626 · (407) 904-4431

Phone(407) 904-4431

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateSeptember 29, 2025

Last NPPES UpdateJanuary 20, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2026

✔ NPI 1902779465 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 FL · OPC6845

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.

11794 E COLONIAL DR, Orlando, FL 32817

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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

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.

PECOS PAC ID8325523467

PECOS Enrollment IDI20260326003517

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 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.

New Patient

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

EYE ASSOCIATES OF MID FLORIDA, P.A.

Optometrist

11794 E COLONIAL DR
ORLANDO, FL 32817

Orange County (407) 904-4431

DR. BRANDON MONDESIR O.D.

Optometrist

11794 E COLONIAL DR
ORLANDO, FL 32817

Orange County (407) 904-4431

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.

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 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.