Rebecca Kozak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002061 Issued in PA

Practice address

160 N Gulph Rd
Lens Crafters
King of Prussia, PA 19406

Phone

(610) 962-5945

Fax

(610) 962-5948

NPI assigned

Jul 2, 2008

Last updated

Jul 29, 2022By 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

Other names 1

• Rebecca Eiss Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Luxottica of America Inc.

  • Point of Service
  • Mason, OH
  • NPI 1831244953

  PA

  Medicare reassignment
• Bling Eyewear, LLC

  • Optician
  • Cranston, RI
  • NPI 1508033853

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1316100126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N GULPH RD",
            "address_2": "LENS CRAFTERS",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "19406",
            "telephone_number": "610-962-5945",
            "fax_number": "610-962-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N GULPH RD",
            "address_2": "LENS CRAFTERS",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "19406",
            "telephone_number": "610-962-5945",
            "fax_number": "610-962-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002061",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316100126",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "EISS",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian M Korff, D.M.D.
• Prachi Dilip Kothari, DO
• Brandon Kotlyar
• Caroline Koury, RBT
• Alexandria Kowal
• Allison Kreider
• Jennifer Kresz, LCSW
• Nicole Kretzinger
• Michele Kreuzer
• Tara Kryman, MA LPC

• Optometrist in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.