Organization Active NPI

Piero a. Simone, M.D., P.C.

  • Eyewear Supplier
  • Macomb, MI
National Provider Identifier
1417374752
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
PS066663 Issued in MI
Legal business name
PIERO A. SIMONE, M.D., P.C.
Practice address
15959 Hall Rd
Suite 202
Macomb, MI 48044-5363
Phone
(586) 558-2981
Fax
(586) 558-8838
NPI assigned
Mar 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Authorized official

Name
Dr. Piero A Simone, MDNPI 1497769624
Title
President
Phone
(586) 558-2981

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X PS066663 MI Primary
Eyewear Supplier 332H00000X JV003935 MI
Eyewear Supplier 332H00000X 4901004738 MI

Addresses

Primary practice location

15959 Hall Rd
Suite 202
Macomb, MI 48044-5363

Mailing address

29245 Ryan Rd
Suite 100
Warren, MI 48092-4284
Phone (586) 558-2981

Other identifiers 1

IdentifierTypeStateIssuer
4397424MedicaidMI

Other names 1

  • Simone Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140418000382 MI DME Supplier - Physician - OphthalmologyDME Supplier - OpticianDME Supplier - Physician - Optometrist 3173556271 Practice locations: Macomb, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2099696Simone Eye Center15959 Hall Road Suite 202, Macomb Township, MI 48044Certificate of waiverJul 30, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Simone Eye Center15959 Hall Rd, Macomb, MI 48044-5366(586) 558-2981 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Sep 6, 2005

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1417374752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29245 RYAN RD",
            "address_2": "SUITE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924284",
            "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": "15959 HALL RD",
            "address_2": "SUITE 202",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445363",
            "telephone_number": "586-558-2981",
            "fax_number": "586-558-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIERO A. SIMONE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "SIMONE",
        "authorized_official_first_name": "PIERO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-558-2981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "PS066663",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "JV003935",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "4901004738",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4397424",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simone Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.