Tesia Reed, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-011470 Issued in IL

Practice address

1469 Starfish LN
Sycamore, IL 60178-8621

Phone

(773) 968-2152

NPI assigned

Apr 2, 2019

Last updated

Jun 27, 2023By 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 6

Addresses

Other identifiers 1

Other names 1

• Tesia Wyszomirski Former name

Medicare fee-for-service enrollment

Enrolled in IL, WI, PA, FL, NY5 enrollments

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 5

Specialty

Optometry

Education

Pacific University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J a K Enterprises IncGroup PAC ID 3173519014, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 54)

Interoperability endpoints

• Direct secure messaging: tesia.reed.1@12125.direct.athenahealth.com

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.

• J a K Enterprises Inc

  dba Bard Optical

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1508856923

  Optometrist

  Medicare reassignment Care Compare group NPD
• Vep Il Optometric LLC

  • Optometrist
  • Bloomington, IL
  • NPI 1528536620
  Medicare reassignment NPD
• Visionworks, Inc.

  dba Visionworks

  • Optometrist
  • Niles, IL
  • NPI 1831115906
  Medicare reassignment NPD
• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  Medicare reassignment NPD
• Aeg Ohio Professional PC

  • Optometrist
  • Solon, OH
  • NPI 1154980811

  PA

  Medicare reassignment NPD
• Aeg Pennsylvania Professional Inc

  dba Eyes on Regent Square

  • Optometrist
  • Pittsburgh, PA
  • NPI 1851958854
  Medicare reassignment NPD
• Blake a Housler OD Inc

  dba Allegheny Eye Care

  • Optometrist
  • Kane, PA
  • NPI 1407046451
  Medicare reassignment NPD
• Myeyedr Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment NPD
• Myeyedr Optometry of Pennsylvania, LLC

  dba MyEyeDr.

  • Optometrist
  • Carlisle, PA
  • NPI 1003264607
  Medicare reassignment NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment NPD
• Shoptikal LLC

  dba Shopko Optical 4002

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment NPD
• Southeast Eye Institute, PA

  dba Eye Associates of Pinellas

  • Ophthalmology Physician
  • Pinellas Park, FL
  • NPI 1073625331

  Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1104388800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540",
            "fax_number": "309-306-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 STARFISH LN",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601788621",
            "telephone_number": "773-968-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "TESIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002688",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "OPT-OPT-LIC-3977",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004021",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3890-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-011470",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "TPOP67",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046011470",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TESIA",
            "last_name": "WYSZOMIRSKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.