JACQUELINE HARTONO OD
NPI 1942936778
Optometrist in New York, NY
About Jacqueline Hartono Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE HARTONO OD (NPI 1942936778) is an individual optometrist in New York, New York, licensed in New York (TUV009616) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
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
Jacqueline Hartono 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 Reassignments
3Medicare enrollment records show Jacqueline Hartono reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New York, NY 10036
- Reassigned Medicare billing, New York enrollment
- 216 clinicians in this Medicare group
Brooklyn, NY 11210
- Reassigned Medicare billing, New York enrollment
- 279 clinicians in this Medicare group
New Hyde Park, NY 11040
- Reassigned Medicare billing, New York enrollment
- 9,353 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 10036 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
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 Jacqueline Hartono's NPI number?
The NPI number for Jacqueline Hartono is 1942936778. It was assigned to this individual provider in the NPPES registry on July 25, 2022.
Where is Jacqueline Hartono located?
Jacqueline Hartono practices at 33 W 42nd St, New York, NY 10036. The listed phone number is (212) 938-4001.
What is Jacqueline Hartono's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Jacqueline Hartono enrolled in Medicare?
Yes. Jacqueline Hartono 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 Jacqueline Hartono's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Hartono reassigns Medicare benefits to 3 organizations: State Of New York Comptrollers Office (New York, NY), Ahava Medical And Rehabilitation Center, LLC (Brooklyn, NY) and North Shore - Lij Medical PC (New Hyde Park, NY). 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 Jacqueline Hartono's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacqueline Hartono accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Jacqueline Hartono 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 Jacqueline Hartono was last updated on August 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Jacqueline Hartono, OD · NPI 1942936778
Optometrist provider in New York, New York. Individual provider, active in the CMS NPPES registry since July 25, 2022.
## Identity
- **NPI:** 1942936778 (Entity type: Individual)
- **Enumerated:** July 25, 2022
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** TUV009616 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 33 W 42ND ST, New York, NY 10036-8005
- **Phone:** (212) 938-4001
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): State Of New York Comptrollers Office (NPI 1407829856, New York, NY); Ahava Medical And Rehabilitation Center, LLC (NPI 1184878274, Brooklyn, NY); North Shore - Lij Medical PC (NPI 1790043479, New Hyde Park, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** August 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1942936778) · Data from the CMS NPPES public registry.