Individual provider Active NPI

Lisa Marie Politza, O.D.

  • Optometrist
  • Joliet, IL
National Provider Identifier
1013055656
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008741 Issued in IL
Practice address
370 Houbolt Rd Ste 102
Joliet, IL 60431-8303
Phone
(815) 729-9143
NPI assigned
Feb 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008741 IL Primary

Addresses

Primary practice location

370 Houbolt Rd Ste 102
Joliet, IL 60431-8303

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

3224 Ridge Rd Ste 102
Lansing, IL 60438-3191
Phone (708) 895-4422

Other names 1

  • Lisa Marie Politza-Termunde Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20221221001068 IN Practitioner - Optometry 7012276405 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
First Impressions Optometric Associates, LLC Optometrist CurrentSince Nov 28, 2022 Accepting new patients
First Impressions Optometric Associates, LLC Optometrist CurrentSince Nov 28, 2022 Accepting new patients
Brand New Day, LLC Optometrist Past Accepting new patients

Locations

2141 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 446-8010

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1013055656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 HOUBOLT RD STE 102",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318303",
            "telephone_number": "815-729-9143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3224 Ridge Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "IL",
            "postal_code": "604383191",
            "country_code": "US",
            "telephone_number": "708-895-4422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLITZA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-04",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "POLITZA-TERMUNDE",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.