Elise M Corgiat, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

222000012 Issued in IL

Practice address

1802 N Division St Ste 205
Morris, IL 60450-3134

Phone

(815) 942-3042

Fax

(815) 942-3062

NPI assigned

Aug 30, 2005

Last updated

Apr 13, 2021By the provider in NPPES

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

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blanco Kays Corgiat Eyecare LLCGroup PAC ID 9436317807, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blanco Kays Corgiat Eyecare, LLC

  • Optometrist
  • Spring Valley, IL
  • NPI 1215204169
  Medicare reassignment Care Compare group
• Six Corners Eye Care LLC

  dba Pearle Vision Six Corners

  • Optometrist
  • Chicago, IL
  • NPI 1629899141
  NPD (past)
• Thaddeus, LTD

  dba Pearle Vision

  • Optometrist
  • Chicago, IL
  • NPI 1831120005
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1831182328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DAKOTA ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621906",
            "telephone_number": "815-663-8281",
            "fax_number": "815-663-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 N DIVISION ST STE 205",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503134",
            "telephone_number": "815-942-3042",
            "fax_number": "815-942-3062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Dakota St",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "IL",
            "postal_code": "613621906",
            "country_code": "US",
            "telephone_number": "815-663-8281",
            "fax_number": "815-663-8190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORGIAT",
        "first_name": "ELISE",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "222000012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222000012",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn M Conaway, P.A.C.
• Kayla M Connor, MOT, OTR/L
• Conrod Chiropractic Clinic LTD.
• Mark Andrew Conrod, DC
• Robin Cook, LCPC
• Kara M Corsiglia, RD, LDN
• Hannah Cowie
• Rita Lee Craven, PA-C
• Mark D Crockett, M.D.
• Kelly L Croegaert, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.