Individual provider Active NPI

Jennifer Dee Killian, O.D

  • Optometrist
  • Middleburg Heights, OH
National Provider Identifier
1508846072
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5584T2498 Issued in OH
Practice address
7225 Old Oak Blvd
B303
Middleburg Heights, OH 44130-3339
Phone
(440) 243-7400
Fax
(440) 243-9034
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5584T2498 OH Primary

Addresses

Primary practice location

7225 Old Oak Blvd
B303
Middleburg Heights, OH 44130-3339

Mailing address

36550 Chester Rd
#403
Avon, OH 44011-1091
Phone (716) 812-7796

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
I20060125001016 OH Practitioner - Optometry 2769451608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Eye Consultants, IncGroup PAC ID 3577537810, 40 clinicians

Practice addresses (Care Compare)

2740 Carnegie Ave
Cleveland, OH 44115-2627
Phone (216) 621-6132

36505 Detroit Rd
Avon, OH 44011-1509
Phone (440) 934-5816

Merit-based Incentive Payment System (MIPS)

Final score
83.55 of 100Reported as group
Quality
81.19
Promoting interoperability
83
Improvement activities
40
Cost
78.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5584T2498OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Eye Consultants Inc CurrentSince Nov 1, 2012 Accepting new patients
Northern Ohio Eye Consultants Inc Optometrist CurrentSince Nov 1, 2012 Accepting new patients

Locations

36505 Detroit Rd
Avon, OH 44011
Phone (216) 390-1020

7001 S Edgerton Rd
#B
Brecksville, OH 44141

6880 W Snowville Rd
Ste 215
Brecksville, OH 44141
Phone (440) 526-1974

2740 Carnegie Ave
Cleveland, OH 44115
Phone (216) 621-6132

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1508846072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36550 CHESTER RD",
            "address_2": "#403",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111091",
            "telephone_number": "716-812-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7225 OLD OAK BLVD",
            "address_2": "B303",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303339",
            "telephone_number": "440-243-7400",
            "fax_number": "440-243-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "JENNIFER",
        "middle_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5584T2498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.