DR. EDWARD MATTHEW ZIMM D.O.
NPI 1609801604
Ophthalmology in Erie, PA

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
91.46/100
CMS Quality Rating
300 STATE ST, SUITE 200, ERIE, PA 16507(814) 453-4575(814) 459-3885 Get Directions Write a Review

NPPES record last updated: March 29, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 29, 2023, Oct 5, 2021, Aug 3, 2021 and 1 more (4 updates tracked since 2021).

About Dr. Edward Matthew Zimm D.o. NPPES

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

DR. EDWARD MATTHEW ZIMM D.O. (NPI 1609801604) is an individual ophthalmology provider in Erie, Pennsylvania, licensed in Pennsylvania (OS014072) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2002).

NPPES Registry Identity

NPI1609801604
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. EDWARD MATTHEW ZIMMCredential: D.O.
Location Address300 STATE ST, SUITE 200Erie, PA 16507-1427
Mailing Address300 State St Ste 200Erie, PA 16507-1429 · (814) 453-4575 · Fax (814) 459-3885
Fax(814) 459-3885
Sole ProprietorYes
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2002
Enumeration DateJuly 11, 2006
Last NPPES UpdateMarch 29, 20234 updates tracked since enumeration
NPPES CertifiedMarch 29, 2023
NPI 1609801604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in PA · OS014072
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.
Also ListedSpecialistTaxonomy 174400000X · License 5101015865 (MI)
300 STATE ST, Erie, PA 16507

Other Identifiers 2

Medicaid4842782MI
Other1852511335MI · Blue Cross & Blue Shield

Accepted 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. Edward Matthew Zimm D.o. 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 ID6709892045
PECOS Enrollment IDI20070725000089
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 10

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.
649 services608 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
426 services403 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.
405 services279 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.
376 services211 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.
217 services217 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.
191 services126 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16507 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

91.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.35
Improvement Activities40
Cost96.4

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
100%23 patients5/55-star benchmark: 100%
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
100%22 patients5/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%23 patients5/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
5 suppliers14 claims14 services$48.76 avg. paid by Medicare
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
5 suppliers15 claims25 services$43.63 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 20

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

Specialist/Technologist (Athletic Trainer)
300 STATE ST, SUITE 106
ERIE, PA 16507
Surgery
300 STATE ST, SUITE 400A
ERIE, PA 16507
Physician Assistant
300 STATE ST, #400A
ERIE, PA 16507
Urology
300 STATE ST, SUITE 301H
ERIE, PA 16507
Nurse Practitioner
300 STATE ST, SUITE 201
ERIE, PA 16507
Optometrist
300 STATE ST, SUITE 202
ERIE, PA 16507
Surgery
300 STATE ST, SUITE 400A
ERIE, PA 16507
Pediatrics
300 STATE ST, SUITE 301
ERIE, PA 16507

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 Edward Zimm's NPI number?

The NPI number for Edward Zimm is 1609801604. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Edward Zimm located?

Edward Zimm practices at 300 State St Suite 200, Erie, PA 16507. The listed phone number is (814) 453-4575.

What is Edward Zimm's specialty?

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

Is Edward Zimm enrolled in Medicare?

Yes. Edward Zimm 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 Edward Zimm accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Edward Zimm 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.

When was this NPI record last updated?

The NPPES record for Edward Zimm was last updated on March 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.