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JASON R KOLODZIEJCZYK O.D.
NPI 1124052626
Optometrist in Fremont, OH

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment
75.56/100
CMS Quality Rating
2311 HAYES AVE, FREMONT, OH 43420(419) 334-8121(419) 332-9351 Get Directions Write a Review

NPPES record last updated: July 11, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jason R Kolodziejczyk O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON R KOLODZIEJCZYK O.D. (NPI 1124052626) is an individual optometrist in Fremont, Ohio, licensed in Ohio (PENDING) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of Ohio State University - College Of Optometry (2006).

NPPES Registry Identity

NPI1124052626
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameJASON R KOLODZIEJCZYKCredential: O.D.
Location Address2311 HAYES AVEFremont, OH 43420-2634
Mailing Address2311 W Hayes AveFremont, OH 43420 · (419) 334-8121 · Fax (419) 332-9351
Phone(419) 334-8121
Fax(419) 332-9351
Sole ProprietorNo
Medical School CMSOhio State University - College Of OptometryGraduated 2006
Enumeration DateJuly 10, 2006
Last NPPES UpdateJuly 11, 2012
✔ NPI 1124052626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in OH · PENDING
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
2311 HAYES AVE, Fremont, OH 43420
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINV09805
Medicaid2677214OH
Medicare PIN4184621

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jason R Kolodziejczyk O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769486513
PECOS Enrollment IDI20060908000359
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
339 services300 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
161 services123 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
118 services116 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
91 services81 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
82 services62 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
28 services28 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital

Acute Care Hospitals · Fremont, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360156
Location715 South Taft AvenueFremont, OH 43420 · Sandusky County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43420 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost18.55

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims18 services$44.91 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ALEXZANDRA RUDINOFF ROTH OD
Optometrist
2311 HAYES AVE, SUITE B
FREMONT, OH 43420
Sandusky County (419) 334-8121
EYE CENTERS OF NORTHWEST OHIO LLC
Optometrist
2311 HAYES AVE, SUITE B
FREMONT, OH 43420
Sandusky County (419) 334-8121
STACY PASCH RELLINGER OD
Optometrist
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121
EYE CENTERS OF NORTHWEST OHIO INC
Eyewear Supplier
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121
GREGORY J DERODES O.D.
Optometrist
2311 HAYES AVE
FREMONT, OH 43420
Sandusky County (419) 334-8121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason Kolodziejczyk's NPI number?

The NPI number for Jason Kolodziejczyk is 1124052626. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Jason Kolodziejczyk located?

Jason Kolodziejczyk practices at 2311 Hayes Ave, Fremont, OH 43420. The listed phone number is (419) 334-8121.

What is Jason Kolodziejczyk's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Jason Kolodziejczyk enrolled in Medicare?

Yes. Jason Kolodziejczyk is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jason Kolodziejczyk accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, MedMutual and Providence Health Plan list Jason Kolodziejczyk as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jason Kolodziejczyk affiliated with any hospitals?

According to CMS data, Jason Kolodziejczyk is affiliated with Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jason Kolodziejczyk was last updated on July 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.