Brenna J Kitzmann, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010972 Issued in IL

Practice address

4600 - 30 Street
Rock Island, IL 61201-7038

Phone

(309) 788-5524

Fax

(309) 788-9550

NPI assigned

Aug 27, 2015

Last updated

Oct 4, 2017By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, IA2 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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prem S Virdi MD PCGroup PAC ID 7113963950, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.26 of 100Reported as individual

Quality

94.52

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bkitzmann@virdi.intellechartdirect.net

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.

• Prem S Virdi MD PC

  dba Virdi Eye Clinic Laser Vision Center

  • Ophthalmology Physician
  • Rock Island, IL
  • NPI 1811950892

  Optometrist

  Medicare reassignment Care Compare group NPD
• Virdi Eye Clinic of Iowa, P.C.

  • Ophthalmology Physician
  • Muscatine, IA
  • NPI 1538139357
  Medicare reassignment
• Virdi Eye Clinic of Iowa

  • Ophthalmology Physician
  • Clinton, IA
  • NPI 1992003677
  NPD (past)

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1154798999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 - 30TH STREET",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017038",
            "telephone_number": "309-788-5524",
            "fax_number": "309-788-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 - 30 STREET",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017038",
            "telephone_number": "309-788-5524",
            "fax_number": "309-788-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZMANN",
        "first_name": "BRENNA",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3449",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010972",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark T Kienle, DDS
• Stefanie Kincaid
• Libna T King, CADC
• Ryan Joseph King
• Carly Kitchell, MSP
• Reagan Klarenbeek
• Ashley Klauss
• Rose E Klinger
• Katelyn Ann Klodnicki
• Patricia Kmetz, BSN, RN

• Optometrist in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.