Individual provider Active NPI

Jeffrey Richard Varanelli, OD

  • Optometrist
  • Warren, MI
National Provider Identifier
1396792016
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003935 Issued in MI
Practice address
29245 Ryan Road
#100 Simone Eye Center
Warren, MI 48092
Phone
(586) 558-2981
Fax
(586) 558-8838
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003935 MI Primary
Ophthalmology Physician 207W00000X 16 MI

Addresses

Primary practice location

29245 Ryan Road
#100 Simone Eye Center
Warren, MI 48092

Mailing address

29245 Ryan Road
#100 Simone Eye Center
Warren, MI 48092-1421
Phone (586) 558-2981

Other identifiers 1

IdentifierTypeStateIssuer
900N834800OtherMIBCBSM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061017000247 MI Practitioner - Optometry 7719983683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piero a Simone MD PCGroup PAC ID 3173556271, 4 clinicians

Practice addresses (Care Compare)

29245 Ryan Rd
Suite 100
Warren, MI 48092-4230
Phone (586) 558-2981

Merit-based Incentive Payment System (MIPS)

Final score
85.39 of 100Reported as group
Quality
100
Improvement activities
40
Cost
51.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003935MIMDOptometrist
16MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piero a. Simone, M.D., P.C. Optometrist CurrentSince Sep 1, 2007 Accepting new patients
Mid Michigan Eye Care Center, PC Optometrist Past Accepting new patients

Locations

15959 Hall Rd
Ste 202
Macomb, MI 48044
Phone (586) 247-5959

29245 Ryan Rd
Ste 100
Warren, MI 48092
Phone (586) 558-2981

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1396792016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29245 RYAN ROAD",
            "address_2": "#100 SIMONE EYE CENTER",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921421",
            "telephone_number": "586-558-2981",
            "fax_number": "586-558-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29245 RYAN ROAD",
            "address_2": "#100 SIMONE EYE CENTER",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-558-2981",
            "fax_number": "586-558-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARANELLI",
        "first_name": "JEFFREY",
        "middle_name": "RICHARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003935",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "16",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "900N834800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.