Tad Robert Kosanovich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2285 Issued in FL

Practice address

150 S Indiana Ave
Englewood, FL 34223-3307

Phone

(941) 473-1392

Fax

(941) 473-9379

NPI assigned

Jan 15, 2007

Last updated

Oct 30, 2008By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Ferris State College - College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tad R Kosanovich OD PA

  • Eyewear Supplier
  • Englewood, FL
  • NPI 1326218215
  Medicare reassignment NPD Authorized official
• Schinderle Eugenides OD PA

  • Optometrist
  • Punta Gorda, FL
  • NPI 1275610958
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1285785527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233307",
            "telephone_number": "941-473-1392",
            "fax_number": "941-473-9379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233307",
            "telephone_number": "941-473-1392",
            "fax_number": "941-473-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSANOVICH",
        "first_name": "TAD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620138500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410046559",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Edward Knapp, MD
• Terri Knight, FNP
• Susan Kollmar, CRNA
• Mark Konwiser, M.D.
• Beena C Koppuzha, M.D.
• Jada L Kouba, LCPC
• Elizabeth G Krupa, RPT
• Jerry E Kuhn, MS, MBA, LMHC
• Maureen Kulsar
• Larry David Kuwik

• Optometrist in Englewood, FL
• Providers in Englewood, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.