Marcia Kostka-Suvelza, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002824 Issued in IN

Practice address

604 I St
La Porte, IN 46350-5530

Phone

(219) 326-8855

Fax

(219) 326-8835

NPI assigned

Dec 14, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkostkasuvelza254007@dulyhealthandcare.direct-ci.com
• FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

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.

• The South Bend Clinic LLC

  • Clinic/Center
  • South Bend, IN
  • NPI 1073680419
  Medicare reassignment Care Compare group NPD
• Dennis R Miller, O.D.

  • Optometrist
  • Warsaw, IN
  • NPI 1003819442
  Medicare reassignment
• The South Bend Clinic, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1487307492
  NPD

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1811972680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 I ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505530",
            "telephone_number": "219-326-8855",
            "fax_number": "219-326-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 I ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505530",
            "telephone_number": "219-326-8855",
            "fax_number": "219-326-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTKA-SUVELZA",
        "first_name": "MARCIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200108470A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Katherine Kirkwood, M.D.
• Danielle Kmiec, MSW, LSW
• George Larsen Kneller, M.D.
• Michael L. Komasinski, O.D.
• Amanda B Kontor
• Emma Krivak
• Michelle M Kroening, RPH
• Kroger Limited Partnership I (Kroger Pharmacy)
• Melissa Kuczmanski, LMHC
• Jody Kupferberg, ARNP

• Optometrist in La Porte, IN
• Providers in La Porte, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.