Sage Simon, is a medicare enrolled "Dietitian, Registered" provider in Lodi, Ohio. Her current practice location is
225 Elyria St, Lodi, Ohio. You can reach out to her office (for appointments etc.) via phone at
(330) 948-1222.
Sage Simon is licensed to practice in Ohio (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457074726.
Healthcare Provider's Profile
| Full Name | Sage Simon |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 225 Elyria St, Lodi, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1457074726
- Provider Enumeration Date: 09/22/2022
- Last Update Date: 09/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 9638542251
- Enrollment ID: I20230302000436
Medical Identifiers
Medical identifiers for Sage Simon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457074726 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sage Simon allows following entities to bill medicare on her behalf.
| Provider Name | Lodi Community Hospital |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1801807870
PECOS PAC ID: 0547237927
Enrollment ID: O20040915000018 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sage Simon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Sage Simon,
1215 W 10th St Apt 832,
Cleveland, OH 44113-1283
Ph: () - | Sage Simon,
225 Elyria St,
Lodi, OH 44254-1031
Ph: (330) 948-1222 |
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