Nicholas Donald Kowalczyk, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

128 Issued in AZ

Practice address

2160 W Chandler Blvd
Suite 19
Chandler, AZ 85224

Phone

(480) 963-3221

Fax

(480) 821-8424

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• LRL Optical Systems, LLC

  • Optician
  • Chandler, AZ
  • NPI 1366986622
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780712901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 W CHANDLER BLVD",
            "address_2": "SUITE 19",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-963-3221",
            "fax_number": "480-821-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 W CHANDLER BLVD",
            "address_2": "SUITE 19",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85224",
            "telephone_number": "480-963-3221",
            "fax_number": "480-821-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "NICHOLAS",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Joseph Kottmer, PHARM.D.
• Dimitra Kourtesi, PH.D., LP
• Deborah Koval
• Kovenant Keepers Home Health LLC
• Stephanie Kovesdy
• Kohei Koyama, PT DPT
• Matilda K. Koyilla, FNP
• Gregory A Kozeny Jr., PHARMD
• Amanda Kraeber
• Jody M Krager, CRNA

• Optometrist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Optometrist in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.