Edward Koutnik II, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3612-35 Issued in WI

Practice address

2300 US Highway 51 and 138 Ste E
Stoughton, WI 53589-2080

Phone

(608) 205-6810

Fax

(608) 205-6813

NPI assigned

Jul 14, 2015

Last updated

Jul 23, 2024By the provider in NPPES

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

Enrolled in WI

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clements Vision CareGroup PAC ID 3971830001, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.koutnik.p7@direct.hauserross.nextgenshare.com

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.

• Clements Vision Care

  • Optometrist
  • Sun Prairie, WI
  • NPI 1720641343
  Medicare reassignment Care Compare group NPD
• Dekalb Eye Consultants, LLC

  dba Arlington Eye Physicians

  • Ophthalmology Physician
  • Sycamore, IL
  • NPI 1326380510

  Optometrist

  NPD
• Rosin Optical Co. Inc.

  dba Skokie Optical

  • Optometrist
  • Skokie, IL
  • NPI 1750945408
  NPD
• Rosin Optical Co., Inc

  • Optometrist
  • Berwyn, IL
  • NPI 1235343641
  NPD
• Rosin Optical Co., Inc.

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1477767796

  Optometrist

  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  NPD
• The Board of Trustees of the University of Illinois

  dba University of Illinois Medical Center at Chicago

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1942244645
  NPD

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1952785578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 US HIGHWAY 51 AND 138 STE E",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892080",
            "telephone_number": "608-205-6810",
            "fax_number": "608-205-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 US HIGHWAY 51 AND 138 STE E",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892080",
            "telephone_number": "608-205-6810",
            "fax_number": "608-205-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTNIK",
        "first_name": "EDWARD",
        "name_suffix": "II",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-14",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3612-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Klosowski, PHARMD
• Robert D Komes, PT
• Malia Kathryn Konsitzke
• Madelyn Rae Kooima
• Brian Kothbauer
• Kratz Family Chiropractic
• Kratz Family Chiropractic
• Douglas Richard Kratz, D.C.
• Dean G Kresge, MD
• Ashleigh E Kreuter, DPT

• Optometrist in Stoughton, WI
• Providers in Stoughton, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.