Individual provider Active NPI

Maria Pica, O.D.

  • Optometrist
  • St Charles, IL
National Provider Identifier
1003975913
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
40W330 Lafox Road
St. Charles, IL 60175
Phone
(630) 584-9850
Fax
(630) 584-1523
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

40W330 Lafox Road
St. Charles, IL 60175

Mailing address

40W330 Lafox Road
St. Charles, IL 60175
Phone (630) 584-9850

Other identifiers 2

IdentifierTypeStateIssuer
46008764MedicaidIL
4519570OtherILBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041129000158 IL Practitioner - Optometry 0749245082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley OphthalmologyGroup PAC ID 6103710652, 7 clinicians

Practice addresses (Care Compare)

40 W330 Lafox Rd
Unit a
Saint Charles, IL 60175-6515
Phone (630) 584-9850

Merit-based Incentive Payment System (MIPS)

Final score
90.18 of 100Reported as group
Quality
97.93
Improvement activities
40
Cost
70.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046008764ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Ophthalmology CurrentSince Oct 1, 2003 Accepting new patients
Fox Valley Ophthalmology PastSince Oct 1, 2003 Accepting new patients

Locations

87 N Airlite St
Ste 240
Elgin, IL 60123
Phone (847) 695-0499

750 Fletcher Dr
Ste 106
Elgin, IL 60123
Phone (847) 695-0499

40W330 Lafox Rd
St Charles, IL 60175
Phone (630) 584-9850

40W330 Lafox Rd
Unit A
St Charles, IL 60175
Phone (630) 584-9850

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1003975913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40W330 LAFOX ROAD",
            "city": "ST. CHARLES",
            "state": "IL",
            "postal_code": "60175",
            "telephone_number": "630-584-9850",
            "fax_number": "630-584-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40W330 LAFOX ROAD",
            "city": "ST. CHARLES",
            "state": "IL",
            "postal_code": "60175",
            "telephone_number": "630-584-9850",
            "fax_number": "630-584-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICA",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46008764",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4519570",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.