Jacqueline Solange Kowal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002627 Issued in AZ

Practice address

1650 E Camelback Rd Ste 160
Phoenix, AZ 85016-3947

Phone

(602) 277-3348

Fax

(602) 264-2715

NPI assigned

Jul 14, 2021

Last updated

Jan 5, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dr.jacqueline.kowal@direct.eyecare-partners.com

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1437721917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-961-1865",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 E CAMELBACK RD STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163947",
            "telephone_number": "602-277-3348",
            "fax_number": "602-264-2715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015568",
            "country_code": "US",
            "telephone_number": "774-826-1106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWAL",
        "first_name": "JACQUELINE",
        "middle_name": "SOLANGE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003684",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Kovacik, M.D.
• Shannon M Kovalcik, NP
• Christina M Kovalik, NMD
• Melissa Kovar, DPT
• David Koven, DO
• James William Kowal, SLPA
• Joanna Kowalik, MD
• John Richard Kowite
• Atsuko Koyama, M.D., M.P.H
• Harrison Koyilla, DO

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.