Individual provider Active NPI

Kristy Marczewski Frank, OD

  • Optometrist
  • Sycamore, IL
National Provider Identifier
1174582191
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009660 Issued in IL
Practice address
2570 Dekalb Ave
Sycamore, IL 60178-3109
Phone
(815) 758-1039
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009660 IL Primary

Addresses

Primary practice location

2570 Dekalb Ave
Sycamore, IL 60178-3109

Mailing address

2570 Dekalb Ave
Sycamore, IL 60178-3109
Phone (815) 758-1039

Other identifiers 1

IdentifierTypeStateIssuer
046009660MedicaidIL

Other names 1

  • Kristy Ann Marczewski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20060227000120 IL Practitioner - Optometry 2264448497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spex Express IncGroup PAC ID 8224019450, 3 clinicians

Practice addresses (Care Compare)

2570 Dekalb Ave
Sycamore, IL 60178-3109

3201 Commerce Dr
Dekalb, IL 60115-8491
Phone (815) 758-1039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009660ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spex Express Inc Optometrist CurrentSince Feb 1, 2009 Accepting new patients

Locations

3251 Commerce Dr
DeKalb, IL 60115
Phone (815) 517-1637

3201 Commerce Dr
DeKalb, IL 60115
Phone (815) 758-1039

2570 DeKalb Ave
Sycamore, IL 60178
Phone (815) 756-2222

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1174582191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 DEKALB AVE",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783109",
            "telephone_number": "815-758-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 DEKALB AVE",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783109",
            "telephone_number": "815-758-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANK",
        "first_name": "KRISTY",
        "middle_name": "MARCZEWSKI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009660",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "MARCZEWSKI",
            "middle_name": "ANN",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.