DR. JAY EGOLF M.D.
NPI 1225085251
Ophthalmology in Portsmouth, OH

Q: What is Jay Egolf's NPI number?

The NPI number for Jay Egolf is 1225085251. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Q: What is Jay Egolf's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jay Egolf was last updated on July 23, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 27, 2006PECOS EnrolledAccepts Medicare Assignment

78.68/100

CMS Quality Rating

1400 GAY ST, PORTSMOUTH, OH 45662(866) 587-8790(740) 774-4061 Get Directions Write a Review

NPPES record last updated: July 23, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Jay Egolf M.d. NPPES

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

DR. JAY EGOLF M.D. (NPI 1225085251) is an individual ophthalmology provider in Portsmouth, Ohio, licensed in Ohio (35083563) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Wilson Memorial Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1225085251

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. JAY EGOLFCredential: M.D.

Location Address1400 GAY STPortsmouth, OH 45662-3475

Mailing Address50 N Plaza BlvdChillicothe, OH 45601-1757 · (866) 587-8790 · Fax (740) 774-4061

Phone(866) 587-8790

Fax(740) 774-4061

Sole ProprietorNo

Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2000

Enumeration DateMay 27, 2006

Last NPPES UpdateJuly 23, 2024

NPPES CertifiedJuly 23, 2024

✔ NPI 1225085251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in OH · 35083563

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1400 GAY ST, Portsmouth, OH 45662

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Secondary Practice Locations 4

Location 11861 Towne Park Dr Ste CTroy, OH 45373-2067 · Phone (513) 984-5133

Location 21118 Fairington DrSidney, OH 45365-8913 · Phone (513) 984-5133

Location 31219 Recker RdPiqua, OH 45356-4113 · Phone (513) 984-5133

Location 41449 S Main StBellefontaine, OH 43311-1503 · Phone (513) 984-5133

Other Identifiers 1

Medicaid2483950OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Dr. Jay Egolf M.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 ID6103819495

PECOS Enrollment IDI20040405000197

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 14

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.

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.

370 services238 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.

369 services275 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

252 services212 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

202 services136 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

186 services126 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).

135 services120 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

106 services106 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.

100 services90 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

87 services26 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

79 services58 patients

Unclassified biologics J3590

Unclassified biologics are a type of treatment derived from living organisms. They can include a wide range of substances, such as vaccines, blood components, or genes, used to prevent or treat diseases. Each is specifically designed to interact with the body's natural defenses to promote healing.

72 services22 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

22 services21 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

13 services13 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.

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Wilson Memorial Hospital

Acute Care Hospitals · Sidney, OH

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360013

Location915 West Michigan StreetSidney, OH 45365 · Shelby County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45662 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.

78.68/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

28.94

Reported Quality Measures

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

92%104 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

85%635 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

98%791 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

95%2,344 patients4/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

60%91 patients3/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

91%2,344 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

1%2,344 patients1/55-star benchmark: 59%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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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 Jay Egolf's NPI number?

The NPI number for Jay Egolf is 1225085251. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Where is Jay Egolf located?

Jay Egolf practices at 1400 Gay St, Portsmouth, OH 45662. The listed phone number is (866) 587-8790.

What is Jay Egolf's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Jay Egolf enrolled in Medicare?

Yes. Jay Egolf 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 Jay Egolf accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Jay Egolf 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 Jay Egolf affiliated with any hospitals?

According to CMS data, Jay Egolf is affiliated with Wilson Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jay Egolf was last updated on July 23, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.