Individual provider Active NPI

Andrew Craig Simon, O.D.

  • Optometrist
  • Bridgeport, CT
National Provider Identifier
1215032453
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002109 Issued in CT
Practice address
2664 E Main St
Bridgeport, CT 06610-1422
Phone
(203) 333-4828
Fax
(203) 336-0049
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002109 CT Primary

Addresses

Primary practice location

2664 E Main St
Bridgeport, CT 06610-1422

Mailing address

2664 E Main St
Bridgeport, CT 06610-1422
Phone (203) 333-4828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100421000002 CT Practitioner - Optometry 3375605702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Center Associates LLCGroup PAC ID 1658433081, 4 clinicians

Practice addresses (Care Compare)

2664 E Main St
Bridgeport, CT 06610-1422
Phone (203) 333-4828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002109CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Center Associates LLC Optometrist CurrentSince May 20, 1987 Accepting new patients

Locations

2664 E Main St
Bridgeport, CT 06610
Phone (203) 333-4828

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215032453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101422",
            "telephone_number": "203-333-4828",
            "fax_number": "203-336-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101422",
            "telephone_number": "203-333-4828",
            "fax_number": "203-336-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ANDREW",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.