Individual provider Active NPI

Krystyna M Katz, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1508450859
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011494 Issued in IL
Practice address
2852 N Halsted St
Chicago, IL 60657-6531
Phone
(773) 549-1111
Fax
(773) 549-1116
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011494 IL Primary

Addresses

Primary practice location

2852 N Halsted St
Chicago, IL 60657-6531

Mailing address

4831 Belmont Rd Unit B
Downers Grove, IL 60515-3242
Phone (847) 567-0502

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
I20210309000826 IL Practitioner - Optometry 1052727583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naper Grove Vision Care, P.C.Group PAC ID 4082696448, 10 clinicians
Halsted Eye Boutique, Inc.Group PAC ID 8022181130, 2 clinicians

Practice addresses (Care Compare)

1331 W 75TH St
Suite 403
Naperville, IL 60540-9311
Phone (630) 357-3511

2852 N Halsted St
Chicago, IL 60657-6531
Phone (773) 549-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Halsted Eye Boutique, Inc. Optometrist CurrentSince Mar 4, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1508450859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4831 BELMONT RD UNIT B",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153242",
            "telephone_number": "847-567-0502",
            "fax_number": "773-549-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576531",
            "telephone_number": "773-549-1111",
            "fax_number": "773-549-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "KRYSTYNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.