Angela Herro Kovacik, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

47164 Issued in AZ

Practice address

18325 N Allied Way
Suite 100
Phoenix, AZ 85054

Phone

(602) 467-4966

Fax

(480) 419-5401

NPI assigned

Jun 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Boston University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Vision IncGroup PAC ID 1658350236, 17 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Millennium Vision Inc

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1184730251
  Medicare reassignment Care Compare group NPD
• L. Allan Eisner M.D., LLC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1497765390
  NPD (past)
• Walman Eye Center, LLC

  • Ophthalmology Physician
  • Sun City, AZ
  • NPI 1215120175
  NPD (past)
• University of Miami

  • Ambulatory Surgical Clinic/Center
  • Palm Beach Gardens, FL
  • NPI 1346317039
  NPD (past)

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1649407883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543105",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIK",
        "first_name": "ANGELA",
        "middle_name": "HERRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R71499",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME115266",
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "AZ",
            "license": "47164",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "47164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17888",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarang Srivathsan Koushik, M.D.
• Emily Jo Kouten, BSN, RN
• Stacy Koutrakos, PSY.D.
• Aaron Kovac, D.C.
• Stephanie Kovach
• Daniel Kovacik, D.M.D., M.P.H
• Jennifer A Kovacik, M.D.
• Shannon M Kovalcik, NP
• Christina M Kovalik, NMD
• Melissa Kovar, DPT

• Ophthalmology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.