Kasem Kasem, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011854 Issued in IL

Practice address

5466 E State St
Rockford, IL 61108-2380

Phone

(815) 398-8703

NPI assigned

May 23, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• Gulf Coast Optometry, PA

  • Corneal and Contact Management Optometrist
  • Tampa, FL
  • NPI 1083859409

  IL

  Medicare reassignment NPD
• National Vision, Inc.

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1417003138
  NPD (past)

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1710726237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 N NORA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606343618",
            "telephone_number": "872-239-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5466 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082380",
            "telephone_number": "815-398-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASEM",
        "first_name": "KASEM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nivedita Karmakar, MD
• Agnieszka S Karpa, PHARM.D
• Austin Karr
• Premanand Karunamurthy, DPT
• Gina Kasel
• Donna Jean Kasper, LCPC
• Ashley Kass
• Kathy Kwiat LCSW PC
• Kathy Kwiat-Hess, LCSW
• Samantha R Kauchak, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.