Elizabeth Ann Kolodzey, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12315T Issued in CA

Practice address

2850 Womble Rd
Suite #106
San Diego, CA 92106-6155

Phone

(619) 523-9990

Fax

(619) 523-9847

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1114134558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 CHANCE MOUNTAIN PL",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919132826",
            "telephone_number": "619-934-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 WOMBLE RD",
            "address_2": "SUITE #106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066155",
            "telephone_number": "619-523-9990",
            "fax_number": "619-523-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODZEY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12315T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ruth Kollisch, M.D.
• Gavin Kolodge
• Alice Kolodji, NP
• David J Kolodji, CRNA
• Rebecca A Kolodner, MD
• Michael Kevin Kolodziej, MFT
• Diana Kolokowsky, DDS
• Crystal Elizabeth Kolos, BA
• Orville G Kolterman, M.D.
• Michael Koltun

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.
• 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.