Agnieszka Krol, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011314 Issued in IL

Practice address

200 N Market Place Dr
Centerville, UT 84014-1752

Phone

(801) 295-7118

Fax

(801) 295-7123

NPI assigned

Jun 18, 2019

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 UT

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

Illinois College of Optometry at Chicago, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Kings Peak Vision PLLC

  • Clinic/Center
  • Centerville, UT
  • NPI 1811613185
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1467012781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 E 4500 S STE 270",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073049",
            "telephone_number": "801-992-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MARKET PLACE DR",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840141752",
            "telephone_number": "801-295-7118",
            "fax_number": "801-295-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROL",
        "first_name": "AGNIESZKA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-12-28",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul M Kanter, DPM
• Zoe Katechis, RDN
• Heather Kearl
• Kings Peak Vision PLLC
• Dennis B. Knoles, DDS
• Carly Kropf
• Ferris M Kunz, RPH
• KVD Care (Heart & Home Assisted Living)
• Neeta Lal, MD
• Shannon Elaine Landheim, L.C.S.W.

• Optometrist in Centerville, UT
• Providers in Centerville, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.