Individual provider Active NPI

Jeffrey Michael Cohen, O.D.

  • Optometrist
  • Sherman Oaks, CA
National Provider Identifier
1104051630
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14338 Issued in CA
Practice address
14006 Riverside Dr Ste 274
Sherman Oaks, CA 91423-1963
Phone
(818) 461-0595
Fax
(818) 461-0596
NPI assigned
May 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4435 FL
Optometrist 152W00000X 14338 CA Primary

Addresses

Primary practice location

14006 Riverside Dr Ste 274
Sherman Oaks, CA 91423-1963

Mailing address

1555 Simi Town Center Way
Ste 575
Simi Valley, CA 93065-0535
Phone (818) 461-0595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120131000716 CA Practitioner - Optometry 2668639824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1555 Simi Town Ctr Way
Suite 575
Simi Valley, CA 93065-0535
Phone (805) 577-0255

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4435FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Cohen, O.D., Inc. Optometrist CurrentSince Oct 16, 2016 Accepting new patients

Locations

1555 Simi Town Center Way
Ste 575
Simi Valley, CA 93065
Phone (805) 526-0279

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1104051630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SIMI TOWN CENTER WAY",
            "address_2": "STE 575",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650535",
            "telephone_number": "818-461-0595",
            "fax_number": "818-461-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14006 RIVERSIDE DR STE 274",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231963",
            "telephone_number": "818-461-0595",
            "fax_number": "818-461-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4435",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.