Jennifer Simon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004645 Issued in MI

Practice address

3935 Lake Michigan Dr NW Ste 3
Grand Rapids, MI 49534-7844

Phone

(872) 806-1663

NPI assigned

Jul 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Ferris State College - College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arsulowicz Eye Care LLCGroup PAC ID 9931428075, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Arsulowicz Eye Care LLC

  • Optometrist
  • Grand Rapids, MI
  • NPI 1508259615
  Medicare reassignment Care Compare group NPD
• Luxottica Retail North America Inc

  • Eyewear Supplier
  • Midland, MI
  • NPI 1053457101
  NPD (past)

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1194012401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 ALEWA DR NW",
            "address_2": "STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045801",
            "telephone_number": "616-916-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 LAKE MICHIGAN DR NW STE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347844",
            "telephone_number": "872-806-1663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2974 28th St SE",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Kentwood",
            "state": "MI",
            "postal_code": "495121664",
            "country_code": "US",
            "telephone_number": "616-949-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Lyn Simmons
• Whisper Jean Simmons
• Jill Simms
• Nancy Debra Simms, MD
• Dalten Tyler Simnitch, ATC
• Juhanna Simon
• Juliana Haley Simon, MD
• Katie Michelle Simon, PA-C
• Nicole Elizabeth Simon, PA-C
• Tonya Anne Simon, PT

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.