Amanda Soukup, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011904 Issued in IL

Practice address

120 E Countryside Pkwy Ste B
Yorkville, IL 60560-1878

Phone

(630) 553-6166

NPI assigned

Aug 9, 2024

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brenart Eye Clinic, LLCGroup PAC ID 1456306851, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brenart Eye Clinic, LLC

  • Optometrist
  • Yorkville, IL
  • NPI 1245307636
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1699506964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E COUNTRYSIDE PKWY STE B",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601878",
            "telephone_number": "630-553-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E COUNTRYSIDE PKWY STE B",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601878",
            "telephone_number": "630-553-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUKUP",
        "first_name": "AMANDA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Lynn Sleezer, MA-LCPC
• Kate Sliker, M.S. CCC - SLP
• Jan C. Smallwood, LPC
• Solidsoul Counseling PLLC
• Kayla Marie Soto
• B. Dawn Spahr, L.C.P.C
• Julius Phillip Spann
• Speckman Therapeutics, LLC
• Jennifer A. Speckman, PT
• Michael Evan Sperlakis, O.D.

• Optometrist in Yorkville, IL
• Providers in Yorkville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.