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FOF OPTICAL PLLC
NPI 1528873684
Optometrist in Bourbonnais, IL

Active since February 07, 2025
372 LARRY POWER RD, BOURBONNAIS, IL 60914(708) 805-7618 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 27, 2025, Feb 7, 2025 (2 updates tracked since 2025).

About Fof Optical Pllc NPPES

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

FOF OPTICAL PLLC (NPI 1528873684), doing business as The Optical Edge, is a healthcare organization registered as an optometrist in Bourbonnais, Illinois and active in the NPI registry since February 2025. The organization lists Lisa Marie Jeziorny Kerouac, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1528873684
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameFOF OPTICAL PLLC
Location Address372 LARRY POWER RDBourbonnais, IL 60914-5190
Mailing Address1158 LafiteBourbonnais, IL 60914-4538 · (708) 805-7618
Phone(708) 805-7618
Organization SubpartNo
Authorized OfficialLisa Marie Jeziorny KerouacOptometrist · (708) 805-7618
Enumeration DateFebruary 7, 2025
Last NPPES UpdateFebruary 27, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2025
✔ NPI 1528873684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
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.
372 LARRY POWER RD, Bourbonnais, IL 60914
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Other Names 1

Doing Business AsThe Optical Edge

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fof Optical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fof Optical PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lisa Jeziorny Kerouac, O.D.
Optometry
NPI 1588951222
372 LARRY POWER RD STE A
Bourbonnais, IL 60914
(815) 216-4600
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Fof Optical PLLC's NPI number?

The NPI number for Fof Optical PLLC is 1528873684. It was assigned to this organization in the NPPES registry on February 7, 2025. The provider is doing business as The Optical Edge.

Where is Fof Optical PLLC located?

Fof Optical PLLC is located at 372 Larry Power Rd, Bourbonnais, IL 60914. The listed phone number is (708) 805-7618.

What is Fof Optical PLLC's specialty?

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

Is Fof Optical PLLC enrolled in Medicare?

Yes. Fof Optical PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fof Optical PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Fof Optical PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Fof Optical PLLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Fof Optical PLLC 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 Fof Optical PLLC was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.