| Katie Lee Simon, OD | |
|
6483 S Westnedge Ave, Portage, MI 49002-3542 | |
| (269) 324-4242 | |
| (269) 324-6145 |
| Full Name | Katie Lee Simon |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 6483 S Westnedge Ave, Portage, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366429581 | NPI | - | NPPES |
| 4551220 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4901004118 (Michigan) | Primary |
| Provider Name | Portage Family Vision Care Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669711438 PECOS PAC ID: 4587186291 Enrollment ID: O20250321001800 |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Lee Simon, OD 6483 S Westnedge Ave, Portage, MI 49002-3542 Ph: (269) 324-4242 | Katie Lee Simon, OD 6483 S Westnedge Ave, Portage, MI 49002-3542 Ph: (269) 324-4242 |
Dr. Katie Lynne Sutter, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6101 Newport Rd Ste A, Portage, MI 49002 Phone: 269-382-6500 Fax: 269-382-2286 | |
Mr. David C Mcclintic, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 6123 S Westnedge Ave, Portage, MI 49002 Phone: 269-327-7079 Fax: 269-327-7165 | |
Dr. Lynnette Raye Blostica, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3412 W Centre Ave, Portage, MI 49024 Phone: 269-329-5860 Fax: 269-329-5865 | |
David P Williams, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 410 E Centre Ave, Portage, MI 49002 Phone: 269-327-4454 Fax: 269-327-8717 | |
Kunjal Patel, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 255 Romence Rd, Portage, MI 49024 Phone: 269-324-0800 | |
West Point Optical Group Optometrist Medicare: Not Enrolled in Medicare Practice Location: 6650 S Westnedge Ave, Suite 232, Portage, MI 49024 Phone: 269-237-2881 | |
Dr. Steven S. Ellinger, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1612 E. Centre Ave., Portage, MI 49002 Phone: 269-329-1030 Fax: 269-329-0966 |