Individual provider Active NPI

Lauren Bozsa, OD

  • Optometrist
  • Edwardsville, IL
National Provider Identifier
1104504034
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2023023897 Issued in MO
Practice address
25 Dunlap Cove Dr
Edwardsville, IL 62025-2489
Phone
(618) 791-0513
NPI assigned
Jul 10, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2023023897 MO Primary

Addresses

Primary practice location

25 Dunlap Cove Dr
Edwardsville, IL 62025-2489

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20231004001445 KS Practitioner - Optometry 9335593722 Reassigns benefits to 1 organization
I20240923000626 MO Practitioner - Optometry 9335593722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acuity Vision Center LLCGroup PAC ID 3971930728, 16 clinicians

Practice addresses (Care Compare)

11114 S Lone Elm Rd
Insight Vision Ctr
Olathe, KS 66061-9434
Phone (913) 390-6700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2190KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paige Hedgpath Odpc Optometrist CurrentSince Jul 5, 2024 Accepting new patients
Acuity Vision Center LLC Optometrist CurrentSince Sep 2, 2023 Accepting new patients
Paige Hedgpath OD,PC Optometrist CurrentSince Jul 5, 2024 Accepting new patients
Insight Vision Center LLC Optometrist PastSince Sep 2, 2023 Accepting new patients
Aeg Oregon Professional LLC Optometrist Past Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

11114 S Lone Elm Rd
Olathe, KS 66061
Phone (913) 390-6700

7355 W 97th St
Overland Park, KS 66212
Phone (913) 648-2021

1400 Forum Blvd
Ste 14
Columbia, MO 65203
Phone (573) 446-0331

323 Monroe St
Jefferson Cty, MO 65101
Phone (573) 635-1313

6708 Raytown Rd
Raytown, MO 64133
Phone (816) 353-1872

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1104504034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DUNLAP COVE DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252489",
            "telephone_number": "618-791-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZSA",
        "first_name": "LAUREN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2023023897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

Verify at the official NPI Registry.