Jennifer V Seibert, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1717 Issued in SC

Practice address

1057 Broad St
#48
Sumter, SC 29150-2567

Phone

(803) 775-8951

Fax

(803) 775-8955

NPI assigned

Jul 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Ms. Jennifer Maria Virag Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

University Alabama Birmingham - School of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bergelt Optometric LLCGroup PAC ID 5092007666, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.seibert.p2@direct.clemsoneye.nextgenshare.com

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.

• Bergelt Optometric LLC

  • Optometrist
  • Florence, SC
  • NPI 1386002467
  Medicare reassignment Care Compare group NPD
• Clemson Eye, PA

  • Optometrist
  • Clemson, SC
  • NPI 1790939254
  NPD (past)

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1154618528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 DAMASCUS CHURCH RD",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290209188",
            "telephone_number": "864-650-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 BROAD ST",
            "address_2": "#48",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502567",
            "telephone_number": "803-775-8951",
            "fax_number": "803-775-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIBERT",
        "first_name": "JENNIFER",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011020051",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MO",
            "license": "2011020051",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MO",
            "license": "2011020051",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154618528",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VIRAG",
            "middle_name": "MARIA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vista Scott
• James Leonard Sease, PT
• Adam Marcus Sebasi, M.D.
• Nicolle Segars, MCD
• Robert Carver Segars, DMD
• Jeffrey S Selman
• Serenity Counseling Services, LLC
• Serenity Day Program
• Serenity Keepers Home Care LLC
• Jacqueline C. Session

• Optometrist in Sumter, SC
• Providers in Sumter, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.