Bruce Jeffries, OD
Individual provider Active NPI Optometrist · Sebring, OH
NPI 1629073440 · NPPES record last updated Nov 25, 2015
Key facts
- NPI
- 1629073440
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 5269/T2177 (OH)
- Practice address
- 331 S 15TH St
PO 278
Sebring, OH 44672-2005 - Phone
- (330) 938-2647
- NPI assigned
- Jun 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dr. Ronald L. Detwiler, O.D. Inc.
Practice addresses (Care Compare)
15655 State Route 170
East Liverpool, OH 43920-9672
Phone (330) 385-3898
331 S 15TH St
Sebring, OH 44672-2005
Phone (330) 938-2647
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 16 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040722000879 | OH | Practitioner - Optometry | 0446230288 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5269 | OH | MD | Counseling Psychologist |
| 5269/T2177 | OH | MD | Optometrist |
| 006378 | NY | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bruce D. Jeffries, O.D. LLC | Current |
Accepting new patients | |
| Dr. Ronald L. Detwiler, O.D. Inc. | Optometrist | Current |
Accepting new patients |
| Dr. Bonnie L. Fields | Optometrist | Past |
Accepting new patients |
| Mobile Medical, Inc. | Past | Accepting new patients | |
| Cleveland Society for the Blind | Past | Accepting new patients | |
| Medina Vision Centre Inc. | Optometrist | Past | Accepting new patients |
| Cleveland Society for the Blind | Optometrist | Past |
Accepting new patients |
| State of New York Comptrollers Office | Past | Accepting new patients |
Locations
15655 State Route 170
Ste P
East Liverpool, OH 43920
Phone (330) 385-3895
10231 Main St
New Middletwn, OH 44442
Phone (330) 542-2381
331 S 15th St
Sebring, OH 44672
Phone (330) 938-2647
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5269/T2177 | OH | Yes |
Addresses
Primary practice location
331 S 15TH St
PO 278
Sebring, OH 44672-2005
Mailing address
331 S 15TH St
Sebring, OH 44672-2005
Phone (330) 938-2647
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2370394 | Medicaid | OH |
Other providers in Sebring, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.