Organization Active NPI

Optica Eye Center Associates, Inc.

  • Optometrist
  • Bloomingdale, IL
National Provider Identifier
1265596209
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009159 Issued in IL
Legal business name
OPTICA EYE CENTER ASSOCIATES, INC.
Practice address
366 W Army Trail Rd
Ste. 310B
Bloomingdale, IL 60108-5601
Phone
(630) 893-1450
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Authorized official

Name
Dr. Carol Lynn Kopke, O.D.NPI 1841354875
Title
Owner
Phone
(630) 893-1450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046009159 IL Primary

Addresses

Primary practice location

366 W Army Trail Rd
Ste. 310B
Bloomingdale, IL 60108-5601

Mailing address

366 W Army Trail Rd
Ste. 310B
Bloomingdale, IL 60108-5601
Phone (630) 893-1450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160202000357 IL Part B Supplier - Clinic/Group Practice 6901100593 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomingdale, IL

National Provider Directory

National Provider Directory

Locations

366 W Army Trail Rd
Ste 310B
Bloomingdale, IL 60108
Phone (630) 893-1450

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1265596209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 W ARMY TRAIL RD",
            "address_2": "STE. 310B",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601085601",
            "telephone_number": "630-893-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 W ARMY TRAIL RD",
            "address_2": "STE. 310B",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601085601",
            "telephone_number": "630-893-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICA EYE CENTER ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "KOPKE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-893-1450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.