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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACOB A KOZISEK OD
NPI 1306075635
Optometrist in Green Bay, WI

Active since July 08, 2009PECOS Enrolled
77.33/100
CMS Quality Rating
2253 W MASON ST, GREEN BAY, WI 54303(920) 327-7000(920) 327-7005 Get Directions Write a Review

NPPES record last updated: August 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 2, 2026, Apr 28, 2026, Apr 9, 2024 and 1 more (4 updates tracked since 2016).

About Jacob A Kozisek Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB A KOZISEK OD (NPI 1306075635) is an individual optometrist in Green Bay, Wisconsin, licensed in Wisconsin (3173) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (2009).

NPPES Registry Identity

NPI1306075635
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameJACOB A KOZISEKCredential: OD
Location Address2253 W MASON STGreen Bay, WI 54303-4706
Mailing Address1035 Kepler DrGreen Bay, WI 54311-8320 · (920) 490-9046 · Fax (920) 405-8005
Phone(920) 327-7000
Fax(920) 327-7005
Sole ProprietorNo
Medical School CMSNew England College Of OptometryGraduated 2009
Enumeration DateJuly 8, 2009
Last NPPES UpdateAugust 2, 20264 updates tracked since enumeration
NPPES CertifiedApril 28, 2026
✔ NPI 1306075635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in WI · 3173
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
2253 W MASON ST, Green Bay, WI 54303
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob A Kozisek Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739232638
PECOS Enrollment IDI20100902000459
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
330 services318 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
174 services174 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
97 services84 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
77 services64 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
59 services57 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
55 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54303 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.22
Promoting Interoperability100
Improvement Activities40
Cost48.23

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE L LOWE APNP
Nurse Practitioner
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 327-7300
BRAD J LAVALLIE OD
Optometrist
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 327-7000
HEIDI KATHRYN BERGMAN PT, DPT
Physical Therapist
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 288-4712
JULIE A MAGNIN M.D.
Family Medicine
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 327-7300
CLINTON B OLSON MD
Family Medicine
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 327-7300
NICHOLAS JAMES HEEZEN D.O.
Internal Medicine
2253 W MASON ST, SUITE 200
GREEN BAY, WI 54303
Brown County (920) 327-7300
DR. MARK R KROLL D.O.
Emergency Medicine
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 327-7000
SHANNA M SEBERO APNP
Nurse Practitioner
2253 W MASON ST
GREEN BAY, WI 54303
Brown County (920) 327-7300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Kozisek's NPI number?

The NPI number for Jacob Kozisek is 1306075635. It was assigned to this individual provider in the NPPES registry on July 8, 2009.

Where is Jacob Kozisek located?

Jacob Kozisek practices at 2253 W Mason St, Green Bay, WI 54303. The listed phone number is (920) 327-7000.

What is Jacob Kozisek's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Jacob Kozisek enrolled in Medicare?

Yes. Jacob Kozisek is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacob Kozisek accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, CareSource (Common Ground Healthcare), HealthPartners and Quartz and 2 other insurers list Jacob Kozisek as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Kozisek was last updated on August 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.