Kaitlyn Elizabeth Kolzow, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00691600 Issued in NJ

Practice address

108 Broughton Ave
Bloomfield, NJ 07003-3999

Phone

(973) 743-1331

NPI assigned

Apr 22, 2020

Last updated

Apr 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alessandra Bertolucci MD LLCGroup PAC ID 6709941859, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22072/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alessandra Bertolucci MD LLC

  dba Associated Eye Physicans

  • Ophthalmology Physician
  • Clifton, NJ
  • NPI 1568617330
  Medicare reassignment Care Compare group NPD
• Associated Eye Physicians, P.a.

  • Ophthalmology Physician
  • Clifton, NJ
  • NPI 1396787685
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1003436791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 WINTERMUTE RD",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078605407",
            "telephone_number": "973-975-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BROUGHTON AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033999",
            "telephone_number": "973-743-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLZOW",
        "first_name": "KAITLYN",
        "middle_name": "ELIZABETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00691600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Niederhoffer Klein, PH.D.
• Dhyana Kluth, REVEREND
• Frederick James Kluth
• Stephanie Rose Koeller, LMFT
• Catherine Colette Koenig, MS, LAT, ATC
• Gregory M. Koufacos, M.A., LCADC
• Evgueni Kovaltchouk, PHARMD
• Wioleta Krzton
• Brooke Elizabeth Kuenzle
• Magdalena Kulesza-Gray, LCADC

• Optometrist in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.