Individual provider Active NPI

Andria M Pihos, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1013900422
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009389 Issued in IL
Practice address
3241 S Michigan Ave
Chicago, IL 60616-3849
Phone
(312) 225-6200
Fax
(312) 949-7660
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009389 IL Primary

Addresses

Primary practice location

3241 S Michigan Ave
Chicago, IL 60616-3849

Mailing address

3241 S Michigan Ave
Chicago, IL 60616-3849
Phone (312) 949-7306

Other identifiers 1

IdentifierTypeStateIssuer
046009389MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100331000978 IL Practitioner - Optometry 4183750904 Reassigns benefits to 1 organization
I20240306000373 WI Practitioner - Optometry 4183750904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois College of OptometryGroup PAC ID 7416851639, 77 clinicians

Practice addresses (Care Compare)

3241 S Michigan Ave
Chicago, IL 60616-3878
Phone (312) 949-7751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3664WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois College of Optometry Optometrist CurrentSince Jul 30, 2001 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Feb 1, 2024 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Feb 1, 2024 Accepting new patients

Locations

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

6000 Monona Dr
Ste 101
Monona, WI 53716
Phone (608) 222-9420

Networks

  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: andria.pihos.iei@direct.ico.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1013900422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163849",
            "telephone_number": "312-949-7306",
            "fax_number": "312-949-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163849",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIHOS",
        "first_name": "ANDRIA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009389",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.