Kathy L Phan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

1520 Spring Hill Mall
Lenscrafters #408
West Dundee, IL 60118-1266

Phone

(847) 426-4624

Fax

(847) 426-5334

NPI assigned

Mar 9, 2007

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 AL, TX2 enrollments

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 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El Paso Optical PCGroup PAC ID 3870611544, 2 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.

• El Paso Optical, P.C.

  • Optometrist
  • El Paso, TX
  • NPI 1609134949
  Medicare reassignment Care Compare group NPD
• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment NPD
• Marc Ellman, M.D., P.a.

  • Ophthalmology Physician
  • El Paso, TX
  • NPI 1053530907
  Medicare reassignment
• Janet B Ogletree OD PA

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710019443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 SPRING HILL MALL",
            "address_2": "LENSCRAFTERS #408",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601181266",
            "telephone_number": "847-426-4624",
            "fax_number": "847-426-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SPRING HILL MALL",
            "address_2": "LENSCRAFTERS #408",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601181266",
            "telephone_number": "847-426-4624",
            "fax_number": "847-426-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KATHY",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Padilla, M.D.
• Jennifer Pate, PT, DPT
• Daxa Patel
• Paul Getz, M.D., S.C.
• Jennifer Lynn Pekovic
• Planet Chiro SC
• Planet Chiro West Dundee Inc.
• Planet Chiropractic West Dundee
• Ricardo Ponce
• Luminita N Popovici, O.D.

• Optometrist in West Dundee, IL
• Providers in West Dundee, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.