Provider Demographics
NPI:1023019262
Name:NERAD, JEFFREY A (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:NERAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 LAKE FOREST DR
Mailing Address - Street 2:STE 600
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3744
Mailing Address - Country:US
Mailing Address - Phone:513-984-5133
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:1945 CEI DRIVE
Practice Address - Street 2:CINCINNATI EYE INSTITUTE
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5664
Practice Address - Country:US
Practice Address - Phone:513-984-5133
Practice Address - Fax:513-569-3941
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01066676A207W00000X
OH35.093522207W00000X
KY42888207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000615045OtherANTHEM BC BS
KY7100077250Medicaid
OH2944943Medicaid
IN200945950Medicaid
OH000000615045OtherBCBS
KY0656032Medicare PIN
IN200945950Medicaid
OH2944943Medicaid
A02339Medicare UPIN