Individual provider Active NPI

Joshua L Korsgarden, O.D.

  • Optometrist
  • Sugar Grove, IL
National Provider Identifier
1821036237
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
047-930861 Issued in IL
Practice address
472 N State Route 47
Suite E
Sugar Grove, IL 60554-8106
Phone
(630) 650-2041
NPI assigned
Jun 4, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 047-930861 IL Primary

Addresses

Primary practice location

472 N State Route 47
Suite E
Sugar Grove, IL 60554-8106

Mailing address

139A Gillett St
Sugar Grove, IL 60554-9323
Phone (630) 650-2041

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040921001052 IL Practitioner - Optometry 1052389624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

472 N Sugar Grove Pkwy
Sugar Grove, IL 60554-8109
Phone (630) 466-4646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047-930861ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joshua L. Korsgarden, O.D., LTD. Optometrist CurrentSince Nov 16, 2009 Accepting new patients
Adams Eyecare, PC Optometrist Past Accepting new patients

Locations

472 Route 47
Ste E
Sugar Grove, IL 60554
Phone (630) 466-4646

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821036237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139A GILLETT ST",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605549323",
            "telephone_number": "630-650-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 N STATE ROUTE 47",
            "address_2": "SUITE E",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605548106",
            "telephone_number": "630-650-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORSGARDEN",
        "first_name": "JOSHUA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "047-930861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Grove, IL

Sources for this page

Verify at the official NPI Registry.