Martin Bruce Simmons, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT006726 Issued in OH

Practice address

4021 Far Hills Ave
Kettering, OH 45429-2413

Phone

(937) 293-2149

Fax

(937) 395-9633

NPI assigned

Jul 6, 2006

Last updated

Nov 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Other names 1

• Martin Bruce Simmons I Professional name

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: martinsimmons@direct.eyecare-partners.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Centerville, OH
  • NPI 1073917597

  KY

  Medicare reassignment Care Compare group
• Clarkson Optometry Midwest Inc.

  dba Clarkson Eyecare

  • Optometrist
  • Lebanon, OH
  • NPI 1326781147
  NPD
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Benton, KY
  • NPI 1114475449
  NPD
• Cincinnati Eye Care Team LLC

  dba Cincinnati Eyecare Team

  • Optometrist
  • West Chester, OH
  • NPI 1760412464
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1588696280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST STE 401",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022667",
            "telephone_number": "814-455-7591",
            "fax_number": "814-454-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 FAR HILLS AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292413",
            "telephone_number": "937-293-2149",
            "fax_number": "937-395-9633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 W 24th St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165022667",
            "country_code": "US",
            "telephone_number": "814-455-7591",
            "fax_number": "814-454-1467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MARTIN",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000681",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT006726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "1863649",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE SR BLUE",
            "identifier": "1863649",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLTH AMERICA",
            "identifier": "27541",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1315299",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016403560001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5106063",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "180649",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLTH ASSURANCE",
            "identifier": "27541",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HLTH PLAN CENTRA",
            "identifier": "1863649",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTIN",
            "last_name": "SIMMONS",
            "middle_name": "BRUCE",
            "suffix": "I",
            "credential": "O.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Steven C. Sierschula, DDS
• Jamie Siesel, D.O.
• Jacob D Sillaman, PA
• Alexandra Sillato
• Sandra K Simi
• Catherine L Simon, P.T.
• Gail Marian Simpson, PCC-S
• Katherine Rachel Simpson, PA-C
• Sarah Simpson, DO
• James A. Sims, M.D.

• Optometrist in Kettering, OH
• Providers in Kettering, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.