Jerome Sude, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3046/T812 Issued in OH

Practice address

3510 Manchester Rd
Coventry Township, OH 44319-1415

Phone

(330) 753-2100

Fax

(330) 633-7165

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

Southern College of Optometry, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cei Physicians PSC, LLCGroup PAC ID 0749186427, 155 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.01 of 100Reported as apm

Quality

86.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerome.sude.p1@direct.cei.nextgenshare.com

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.

• Cei Physicians PSC LLC

  • Ophthalmology Physician
  • Cincinnati, OH
  • NPI 1942296298

  Optometrist

  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Midwest Inc

  • Optometrist
  • Centerville, OH
  • NPI 1073917597
  Medicare reassignment
• Cei Physicians PSC, LLC

  • Ambulatory Surgical Clinic/Center
  • Richmond Heights, OH
  • NPI 1891406328
  NPD
• Clarkson Optometry Midwest Inc

  • Optometrist
  • Wooster, OH
  • NPI 1396325130
  NPD
• Cei Physicians PSC LLC

  • Ophthalmologic Surgery Clinic/Center
  • Blue Ash, OH
  • NPI 1790772804
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1982607727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753202117",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 MANCHESTER RD",
            "city": "COVENTRY TOWNSHIP",
            "state": "OH",
            "postal_code": "443191415",
            "telephone_number": "330-753-2100",
            "fax_number": "330-633-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDE",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3046/T812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1418274",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410022025",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0655759",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMA",
            "identifier": "341572960B",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "728946",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000134329",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4338408",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0505046",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Marie Shine, LAT, ATC
• Tierney L Shumaker
• Troy J Sidner, CT
• Galen W. Sievert, PCC-S, LICDC-CS
• Charles Spahr
• Summa Physicians LLC
• Summa Physicians LLC
• Michael George Swartout, CDCA
• Tender Love and Care Services LLC
• Lisa M Testa, O.D.

• Optometrist in Coventry Township, OH
• Providers in Coventry Township, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.