Individual provider Active NPI

Paul S Kirschner, OD

  • Optometrist
  • Homewood, IL
National Provider Identifier
1407867534
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
2156 W 183Rd Street
Homewood, IL 60430
Phone
(708) 957-7700
Fax
(708) 957-7715
NPI assigned
Aug 11, 2006
Last updated
Sep 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

2156 W 183Rd Street
Homewood, IL 60430

Mailing address

2156 W 183Rd Street
Homewood, IL 60430
Phone (708) 957-7700

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
I20120905000079 IL Practitioner - Optometry 8123033289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosin Optical Co IncGroup PAC ID 8022921758, 51 clinicians

Practice addresses (Care Compare)

2156 183Rd St
Homewood, IL 60430-3238
Phone (708) 957-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.006983ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosin Optical Co. Inc. Optometrist CurrentSince Jan 2, 2019 Accepting new patients
Rosin Optical Co., Inc Optometrist Current Accepting new patients
Rosin Optical Co. Inc. Optometrist CurrentSince Jan 2, 2019 Accepting new patients
Rosin Optical Co., Inc. Optometrist Past Accepting new patients

Locations

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

2156 183rd St
Homewood, IL 60430
Phone (708) 957-7700

7026 W 159th St
Orland Park, IL 60462
Phone (708) 687-0600

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1407867534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 W 183RD STREET",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "708-957-7700",
            "fax_number": "708-957-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 W 183RD STREET",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "708-957-7700",
            "fax_number": "708-957-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHNER",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.