Active NPI
Anna Katrina Pamula, OD
- Optometrist
- Rockford, IL
National Provider Identifier
1023728995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011686
- Practice address
- 1603 N Alpine Rd Ste 121
Rockford, IL 61107-1439 - Phone
- (815) 397-5959
- NPI assigned
- Dec 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.011686 | IL | Primary |
Addresses
Primary practice location
1603 N Alpine Rd Ste 121
Rockford, IL 61107-1439
Mailing address
8872 Jody LN Apt 2E
Des Plaines, IL 60016-7302
Phone (773) 931-0813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011686 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christina J. Levi O D P C | Optometrist | Current | Accepting new patients |
| Christina J. Levi O D P C | Optometrist | Past | Accepting new patients |
Locations
111 E 4th St
Ste 440
Alton, IL 62002
2100 Troy Rd
Edwardsville, IL 62025
Phone (618) 656-8888
1603 N Alpine Rd
Ste 121
Rockford, IL 61107
Phone (815) 397-5959
Organizations & group practices 2
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.
-
- Optometrist
- Edwardsville, IL
- NPI 1477703411
-
- Optometrist
- Edwardsville, IL
- NPI 1033261904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1023728995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8872 JODY LN APT 2E",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600167302",
"telephone_number": "773-931-0813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1603 N ALPINE RD STE 121",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611071439",
"telephone_number": "815-397-5959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAMULA",
"first_name": "ANNA",
"middle_name": "KATRINA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-01",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.