Dr Keith A Simon, OD is a medicare enrolled "Optometrist" provider in Venice, California. He graduated from medical school in 1995 and has 29 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Venice Family Clinic and his current practice location is
604 Rose Ave, Venice Family Clinic/optometry Dept., Venice, California. You can reach out to his office (for appointments etc.) via phone at
(310) 392-8636.
Dr Keith A Simon is licensed to practice in California (license number 10592 TPG) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1821069311.
Healthcare Provider's Profile
| Full Name | Dr Keith A Simon |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 29 Years |
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| Location | 604 Rose Ave, Venice, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Keith A Simon graduated from medical school in 1995
NPI Data:
- NPI Number: 1821069311
- Provider Enumeration Date: 02/01/2006
- Last Update Date: 02/18/2021
Medicare PECOS Information:
- PECOS PAC ID: 7719319532
- Enrollment ID: I20191118000673
Medical Identifiers
Medical identifiers for Dr Keith A Simon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1821069311 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 10592 TPG (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Venice Family Clinic | 2264339126 | 50 |
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. Dr Keith A Simon allows following entities to bill medicare on his behalf.
| Provider Name | Venice Family Clinic |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1669418513
PECOS PAC ID: 2264339126
Enrollment ID: O20031217001082 |
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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. Dr Keith A 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 |
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Dr Keith A Simon, OD
Po Box 57624,
Sherman Oaks, CA 91413-2624
Ph: () - | Dr Keith A Simon, OD
604 Rose Ave, Venice Family Clinic/optometry Dept.,
Venice, CA 90291-2767
Ph: (310) 392-8636 |
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