Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Jeanes

Individual provider Optometrist · NPI 1043909229

Derek Jeanes is an Optometry in Prescott, Arizona. Qualified in 2023, 3 years ago. Practices with Eye Doctors of Arizona PLLC, an 11-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
3
Licensed in
AZ
In the registry since
2023
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Practice location Address checks out

3192 Willow Creek Rd
Prescott, AZ 86301-6610
Phone: (928) 445-1234
Fax: (602) 508-4830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 399 W Palomino Rd, Chino Valley, AZ 86323-5648 — (928) 636-5504
  • 3223 N Windsong Dr, Prescott Valley, AZ 86314-1222 — (928) 775-6121

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT-002719 (AZ)

Record details

NPI number1043909229
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 3, 2023
Last updated in NPPESJuly 19, 2023
Certification dateJuly 19, 2023
Mailing address63 S Rockford Dr Ste 220, Tempe, AZ 85288-6226

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Eye Doctors Of Arizona Pllc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Prescott