Cassandra Anne Koutnik, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010904 Issued in IL

Practice address

2121 W Division St
Chicago, IL 60622-2948

Phone

(773) 697-7370

NPI assigned

Jul 21, 2015

Sex

Female

Sole proprietor

Yes

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.

• Village Eye Care LTD

  • Optometrist
  • Chicago, IL
  • NPI 1477601664

  IL, Optometrist

  Medicare reassignment NPD
• Suburban Eye Specialists

  • Ophthalmology Physician
  • Chicago Ridge, IL
  • NPI 1043794506

  IL

  Medicare reassignment
• D J Dawson MD Incorporated

  • Ophthalmology Physician
  • Munster, IN
  • NPI 1558644476
  NPD (past)

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

• Ms. Cassandra Anne Weinfurter Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2020.

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1093190019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222948",
            "telephone_number": "773-697-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222948",
            "telephone_number": "773-697-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTNIK",
        "first_name": "CASSANDRA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "WEINFURTER",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ioannis Kourafas, PHARMD
• Kimberly Kouretchian, RN, IBCLC
• Christine Kouria
• George J Kouris, M.D.
• Kourosh Dini MD LTD
• Theodore Kypreos Koutouzis, MD
• Demetra Eleni Koutras, APRN, CRNA
• Stephanie Koutsky, M.S., BCBA
• Ena Kovac
• Maegan Kovac, DT

• All providers in Chicago, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.