Eric Kitzmann, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

078446 Issued in IA

Practice address

4310 E 53Rd St
Davenport, IA 52807-3039

Phone

(563) 324-2020

NPI assigned

Jun 15, 2015

Sex

Male

Sole proprietor

No

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 IA

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

Illinois College of Optometry at Chicago, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Pavilion PLCGroup PAC ID 2062460843, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Care Pavilion PLC

  • Optometrist
  • Davenport, IA
  • NPI 1083684211
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1134500200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073039",
            "telephone_number": "563-324-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073039",
            "telephone_number": "563-324-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZMANN",
        "first_name": "ERIC",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "078446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Kingma, D.D.S., M.S.
• Tara M Kinney, CRNA
• Lynette Kirk, LISW
• Chelsie Kirschbaum
• Jacqueline Elizabeth Kitchen, M.D.
• Susan Langewisch Kivisto
• Kizmit LLC
• Kathryn Louise Klauer, H.I.S.
• Tandem Elysia Klauer, REGISTERED NURSE
• Macey Kathryn Kleitsch

• Optometrist in Davenport, IA
• Providers in Davenport, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.