Eric M Kolisz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001943 Issued in GA

Practice address

4380 Kings Way
Valdosta, GA 31602-6921

Phone

(229) 391-4126

Fax

(229) 391-4392

NPI assigned

Mar 21, 2006

Last updated

Sep 6, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

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

Indiana University - School of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Georgia Eye Partners PCGroup PAC ID 3375671589, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekolisz@esp.intellechartdirect.net

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.

• South Georgia Eye Partners PC

  • Ophthalmology Physician
  • Valdosta, GA
  • NPI 1922321728

  Optometrist

  Medicare reassignment Care Compare group NPD
• Gainesville Eye Associates LLC

  • Ophthalmology Physician
  • Gainesville, GA
  • NPI 1285617647

  Optometrist

  NPD
• Steven M. Wilson, O.D., P.C.

  dba Wilson Eye Center

  • Optometrist
  • Valdosta, GA
  • NPI 1750506671
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1508825175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026921",
            "telephone_number": "229-391-4126",
            "fax_number": "229-391-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026921",
            "telephone_number": "229-391-4126",
            "fax_number": "229-391-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLISZ",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS  MEDICAID",
            "identifier": "92033",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "07566",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/PALMETTO DME",
            "identifier": "081184001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS GROUP",
            "identifier": "44257",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhea L Kisling, LPC
• Cheryl M Kitchel, CNM
• John Klimko Jr.
• Mikki Powell Knight, PHARM.D.
• Nyesia Knight, LCSW
• Kool Smiles, PC
• Eli Kosciw
• Tiffany Kouadio, DPT
• Chase Kriebel, ATC
• Andrea Paige Krispin, NP-C

• Optometrist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.