Katelyn Wang Bult

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011623 Issued in IL

Practice address

5408 N Clark St
Chicago, IL 60640-1210

Phone

(773) 275-2020

NPI assigned

May 25, 2022

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

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Illinois LLCGroup PAC ID 3577869965, 66 clinicians

Practice addresses (Care Compare)

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.

• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1245695378
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Oak Lawn, IL
  • NPI 1003361478
  NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1154297752
  NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Evanston, IL
  • NPI 1396100434
  NPD (past)

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1902544265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5408 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401210",
            "telephone_number": "773-275-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2842 N Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576174",
            "country_code": "US",
            "telephone_number": "773-975-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULT",
        "first_name": "KATELYN",
        "middle_name": "WANG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Bullock, LCSW
• Shanquinnell Bullock, LCPC
• Bullseye Testing, LLC
• Jennifer K Bulmann, O.D.
• Judiynn Bult, PHARMD,BCPS
• Serdar Bulun, MD
• Leslie Bulyaki, D.C
• Emma Bulzoni, LPC
• Jenna Lynn Bumber, LCPC
• Becky D. Bumhira, L.C.P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.