Kelly Cohen

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011431 Issued in IL

Practice address

350 S Northwest Hwy Ste 104
Park Ridge, IL 60068-4262

Phone

(847) 823-8283

Fax

(847) 823-1099

NPI assigned

May 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Ridge Vision LLCGroup PAC ID 1052646437, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Park Ridge Vision LLC

  dba Park Ridge Vision

  • Optometrist
  • Park Ridge, IL
  • NPI 1225697675
  Medicare reassignment Care Compare group NPD
• Illinois College of Optometry

  dba Illinois Eye Institute

  • Optometrist
  • Chicago, IL
  • NPI 1285612390
  Medicare reassignment NPD

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1447871959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY STE 104",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684262",
            "telephone_number": "847-823-8283",
            "fax_number": "847-823-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY STE 104",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684262",
            "telephone_number": "847-823-8283",
            "fax_number": "847-823-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christin Coffey, M.A., LPC
• Marie C Cogley, MSN, APRN, FNP-BC
• Cognitive Behavioral Health Inc
• David Goldsmith Cohen, MD
• Karen Ann Cohen, LCSW
• Ursula Patricia Colareta Ugarte, M.D.
• Cole D Lundquist MD SC
• Jerome N Colletti
• James A Colombo, MD
• Bernard Colonna

• Optometrist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.
• 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.