Kevin Michael Simmons, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN3454 Issued in MN

Practice address

14645 Bel Red Rd
Building E, Ste 102
Bellevue, WA 98007-3929

Phone

(425) 432-6056

NPI assigned

Jul 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kevy Michael Simmons Other name

Medicare fee-for-service enrollment

Enrolled in MN

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

Pacific University - College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinecone Vision Center, PAGroup PAC ID 6800786906, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

64.31 of 100Reported as group

Quality

35

Promoting interoperability

98

Improvement activities

40

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.

• Pinecone Vision Center, PA

  • Optometrist
  • Sartell, MN
  • NPI 1790830701
  Medicare reassignment Care Compare group NPD
• Pinecone Vision Center, PA

  • Optometrist
  • St. Cloud, MN
  • NPI 1295468098
  NPD
• Northwest Pediatric Eye Care P.S.

  • Pediatric Optometrist
  • Bellevue, WA
  • NPI 1730399049

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1407101892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 TROOP DR",
            "address_2": "APT D104",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774563",
            "telephone_number": "320-258-3915",
            "fax_number": "320-258-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 BEL RED RD",
            "address_2": "BUILDING E, STE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073929",
            "telephone_number": "425-432-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN3454",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MN",
            "license": "MN3454",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MN",
            "license": "MN3454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVY",
            "last_name": "SIMMONS",
            "middle_name": "MICHAEL",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Magda Nicole Sim, RD
• Jean Nangila Simekha
• Cherylena Elizabeth Simmonds, D.C.
• Christina Noel Simmons, LMP
• Cuyler Ann Simmons, MSW, LSWAIC, CDPT
• Erin Simon, PT
• Ilana Adina Simon, PA-C
• James Lee Simon, LMT
• Joni C Simon, MPT
• Trina Annett Simon

• Optometrist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.