Kathleen M Rivera - Kunz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008908 Issued in IL

Practice address

408 W 2ND St
Centralia, IL 62801-3402

Phone

(618) 532-5531

Fax

(618) 532-6706

NPI assigned

Jun 18, 2005

Last updated

Jun 3, 2009By 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 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry Illinois, PCGroup PAC ID 7012292147, 16 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleenrivera@direct.eyecare-partners.com

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.

• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Ballwin, MO
  • NPI 1548635758

  IL

  Medicare reassignment Care Compare group NPD
• JFJ Eyecare, LTD

  dba Quantum Vision Centers

  • Optometrist
  • Swansea, IL
  • NPI 1376586685
  Medicare reassignment NPD
• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Centralia, IL
  • NPI 1730373648
  NPD
• Clarkson Optometry Illinois PC

  • Optometrist
  • Shiloh, IL
  • NPI 1457303125
  NPD (past)
• Illinois Retina Surgery LTD

  • Ophthalmic Technician/Technologist
  • Swansea, IL
  • NPI 1255374559
  NPD (past)

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1235134982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W 2ND ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013402",
            "telephone_number": "618-532-5531",
            "fax_number": "618-532-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W 2ND ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013402",
            "telephone_number": "618-532-5531",
            "fax_number": "618-532-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA - KUNZ",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-18",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008908 2",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renal Life Link Inc (Centralia Dialysis)
• Maria Riaz, MD
• Stephen Bradford Richards, MSED
• Heather Rittenhouse
• Amy Lee Ritzheimer, O.D.
• James Douaedf Rueter, CRNA
• Julie Ann Rueter, M.S.W., L.S.W.
• David Rugowski, LCPC
• Lisa Marie Russow
• Usha Kiran Sadanala, MD

• Optometrist in Centralia, IL
• Providers in Centralia, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.