Individual provider Active NPI

Jessica A Simon, O.D.

  • Optometrist
  • Stow, OH
National Provider Identifier
1790785285
Registry record updated Jun 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5416 Issued in OH
Practice address
3330 Kent Rd
Stow, OH 44224-4537
Phone
(330) 688-8811
Fax
(330) 296-3231
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5416 OH Primary

Addresses

Primary practice location

3330 Kent Rd
Stow, OH 44224-4537

Mailing address

518 West Ave
Tallmadge, OH 44278-2117
Phone (330) 630-9699

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
I20040820000877 OH Practitioner - Optometry 7911971403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cei Physicians PSC, LLC 155 clinicians
Linda M Sedlacek O.D. and Associates Inc 2 clinicians

Practice addresses (Care Compare)

1945 Cei Dr
Blue Ash, OH 45242-5664
Phone 51398451333741

4153 Bridgewater Pkwy
Stow, OH 44224-6191
Phone (330) 922-4393

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Oct 13, 2021 Accepting new patients
Cei Physicians PSC LLC Optometrist CurrentSince Apr 1, 2022 Accepting new patients
Linda M Sedlacek O.D. & Associates Inc Optometrist CurrentSince Nov 16, 2019 Accepting new patients
Cei Physicians PSC, LLC CurrentSince Apr 1, 2022 Accepting new patients
Cei Physicians PSC LLC Past Accepting new patients

Locations

1945 Cei Dr
Blue Ash, OH 45242

8118 Montgomery Rd
Cincinnati, OH 45236
Phone (513) 891-9030

4153 Bridgewater Pkwy
Stow, OH 44224
Phone (330) 922-4393

518 West Ave
Tallmadge, OH 44278
Phone (216) 630-9699

Interoperability endpoints

  • Direct secure messaging: jessica.simon.p1@direct.cei.nextgenshare.com

Organizations & group practices 8

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561852800000",
    "number": "1790785285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 WEST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782117",
            "telephone_number": "330-630-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 KENT RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442244537",
            "telephone_number": "330-688-8811",
            "fax_number": "330-296-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2019-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

Verify at the official NPI Registry.