Individual provider Active NPI

Jayce Simoncic, MD

  • Ophthalmology Physician
  • Columbia, MO
National Provider Identifier
1053907923
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2024019077 Issued in MO
Practice address
1 Hospital Dr # Dc052.00
Columbia, MO 65212-0786
Phone
(660) 620-9710
NPI assigned
Dec 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X 2024019077 MO Primary

Addresses

Primary practice location

1 Hospital Dr # Dc052.00
Columbia, MO 65212-0786

Mailing address

1 Hospital Dr # Dc052.00
Columbia, MO 65212-0786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725004152 MO Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 7012453087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1053907923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC052.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC052.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120786",
            "telephone_number": "660-620-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONCIC",
        "first_name": "JAYCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-15",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2024019077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.