Kenneth Ronald Minarik, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007285 Issued in IL

Practice address

8530 N 2ND St
Machesney Park, IL 61115-2414

Phone

(815) 654-7777

Fax

(815) 654-7902

NPI assigned

Nov 7, 2006

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 1

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

Illinois College of Optometry at Chicago, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

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.

• Shoptikal LLC

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1699331082

  Optometrist

  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1245695378
  Medicare reassignment NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1154297752
  NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1427413327
  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Huntley, IL
  • NPI 1710512801

  Optometrist

  NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1598834293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 N 2ND ST",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611152414",
            "telephone_number": "815-654-7777",
            "fax_number": "815-654-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINARIK",
        "first_name": "KENNETH",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08123272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mercyhealth Visiting Nurses Association, Inc.
• MH Health Care Services, PC
• Benjamin P Miers, DPT
• Cathy S Miller, M.A., CCC-SLP
• Molly Miller, MS, CCC-SLP
• Nathan William Mogren, D.M.D.
• Barbara Lynn Mondik, MD
• Taehyung Moon, DDS
• Jordyn Morris
• Stanley Njaramba Muthami, OTR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.