Jason R Kolodziejczyk, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

PENDING Issued in OH

Practice address

2311 Hayes Ave
Fremont, OH 43420-2634

Phone

(419) 334-8121

Fax

(419) 332-9351

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Centers of Northwest Ohio LLCGroup PAC ID 0446314892, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.38 of 100Reported as group

Quality

97.11

Improvement activities

40

Cost

78.46

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Centers of Northwest Ohio LLC

  • Optometrist
  • Fremont, OH
  • NPI 1124284518
  Medicare reassignment Care Compare group NPD
• Michael D Hipsher, OD

  • Durable Medical Equipment & Medical Supplies
  • Fostoria, OH
  • NPI 1184896888
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1124052626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 W HAYES AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "43420",
            "telephone_number": "419-334-8121",
            "fax_number": "419-332-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 HAYES AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202634",
            "telephone_number": "419-334-8121",
            "fax_number": "419-332-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODZIEJCZYK",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2677214",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randal Koch, RPH
• Michael Allen Koebel, RN.
• Janet Koerper, P.T., D.P.T.
• Heather S Kolkemeyer, LPTA
• Fredricka Kollsmith
• Kosta Health Promotions LLC
• Joanne Kosta, LPCC
• Kristin Kowing
• Alyssa Kromer
• Lisa Krotzer, CNP

• Optometrist in Fremont, OH
• Providers in Fremont, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.