NPIMap

Organization Active NPI

Koziol-Thoms Eye Associates S.C.

  • Ophthalmology Physician
  • Arlington Heights, IL
National Provider Identifier
1619901865
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KOZIOL-THOMS EYE ASSOCIATES S.C.
Practice address
1211 S Arlington Heights Rd
Arlington Heights, IL 60005-3142
Phone
(847) 259-2777
Fax
(847) 437-6841
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Jeffrey E Koziol, M.D.NPI 1891713947
Title
Physician/Owner
Phone
(847) 259-2777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1211 S Arlington Heights Rd
Arlington Heights, IL 60005-3142

Mailing address

1211 S Arlington Heights Rd
Arlington Heights, IL 60005-3142
Phone (847) 259-2777

Other identifiers 1

IdentifierTypeStateIssuer
CA2008OtherILMEDICARE RAILROAD RETIREM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216001218 IL Part B Supplier - Clinic/Group Practice 4385539758 Receives reassigned benefits from 7 practitioners
Practice locations: Arlington Heights, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Koziol-Thoms Eye Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1211 S Arlington Heights Rd
#R
Arlington Heights, IL 60005
Phone (847) 264-2222

1211 S Arlington Heights Rd
Arlington Heights, IL 60005
Phone (847) 259-2777

Interoperability endpoints

  • Direct secure messaging: rali@ktbea.intellechartdirect.net
  • Direct secure messaging: lauerbach@ktbea.intellechartdirect.net
  • Direct secure messaging: oboundaoui@ktbea.intellechartdirect.net
  • Direct secure messaging: jcarlson@ktbea.intellechartdirect.net
  • Direct secure messaging: mthoms@ktbea.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1619901865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053142",
            "telephone_number": "847-259-2777",
            "fax_number": "847-437-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053142",
            "telephone_number": "847-259-2777",
            "fax_number": "847-437-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOZIOL-THOMS EYE ASSOCIATES S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "847-259-2777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD RETIREM",
            "identifier": "CA2008",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.