EMILY KOZICZKOWSKI (OD, MS) – Optometrist, NPI 1568251700

EMILY KOZICZKOWSKI (OD, MS) is a healthcare provider. based in Lacey, Washington. specializing in OPTOMETRY. They hold the professional credentials OD, MS. They hold a License No. INPROGRESS (OH). The NPI Number for EMILY KOZICZKOWSKI (OD, MS) is 1568251700

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
EMILY KOZICZKOWSKI (OD, MS)
NPI
1568251700
Phone
(360) 456-3200
Address
345 College St SE Ste C
Enumeration Date
5 May 2025
Last Update Date
7 October 2025

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
3604563200
Graduation Year
2025 (1 year ago)
PAC ID
0244734358
Group Practice PAC ID
8123916962
Professional Enrollment ID
I20250919002913
Address ID
WA985065030OL215XXNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

Provider Addresses for EMILY KOZICZKOWSKI (OD, MS)

  • 345 College St SE Ste C

    Lacey, WA 985031014

    Phone: (360) 456-3200

    Fax: (360) 456-3894

    Type: Location

  • 345 COLLEGE ST SE STE C

    LACEY, WA 985031014

    Phone: (360) 456-3200

    Fax: (360) 456-3894

    Type: Mailing

  • 6300 SAWMILL RD

    DUBLIN, OH 430171470

    Phone: (614) 726-7256

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250919002913IOptometryWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123916962View full group profile
NameSpecialtyState
O P H T H A L M O L O G YWA
O P H T H A L M O L O G YCA
O P T O M E T R YWA
O P H T H A L M O L O G YWA
O P T O M E T R YIL
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YWA
O P H T H A L M O L O G YWA
O P H T H A L M O L O G YWA

Reviews

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Frequently asked questions

What is EMILY KOZICZKOWSKI (OD, MS)'s NPI number?
EMILY KOZICZKOWSKI (OD, MS)'s NPI is 1568251700 — the number used across U.S. healthcare to identify this provider.
Would EMILY KOZICZKOWSKI (OD, MS) appear as active to a payer?
You can treat EMILY KOZICZKOWSKI (OD, MS) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to EMILY KOZICZKOWSKI (OD, MS)?
EMILY KOZICZKOWSKI (OD, MS)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Is EMILY KOZICZKOWSKI (OD, MS) associated with Lacey?
Public fields place EMILY KOZICZKOWSKI (OD, MS) around Lacey, Washington. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for EMILY KOZICZKOWSKI (OD, MS) is noted as May 5, 2025 where the registry provides it.

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