Individual provider Active NPI

Jordan Spiess, OD

  • Optometrist
  • Bryan, OH
National Provider Identifier
1295319655
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.006962 Issued in OH
Practice address
1313 W High St
Bryan, OH 43506-1545
Phone
(419) 636-1531
NPI assigned
May 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.006962 OH Primary

Addresses

Primary practice location

1313 W High St
Bryan, OH 43506-1545

Mailing address

431 Parkview Ave
Bryan, OH 43506-1636
Phone (567) 239-6575

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210719002108 OH Practitioner - Optometry 6800299512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 clinicians

Practice addresses (Care Compare)

1313 W High St
Bryan, OH 43506-1545
Phone (419) 636-1531

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.006962OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Ohio Professional PC Optometrist CurrentSince Apr 16, 2021 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Apr 16, 2021 Accepting new patients

Locations

1313 W High St
Bryan, OH 43506
Phone (419) 636-1531

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

3723 King Rd
Ste 100
Toledo, OH 43617
Phone (419) 843-2020

Organizations & group practices 2

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1295319655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 PARKVIEW AVE",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061636",
            "telephone_number": "567-239-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061545",
            "telephone_number": "419-636-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIESS",
        "first_name": "JORDAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.