Tamara R Fountain, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

036085597 Issued in IL

Practice address

740 Waukegan Rd
Suite 360
Deerfield, IL 60015-4374

Phone

(847) 945-6770

Fax

(847) 945-3159

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Harvard Medical School, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Center Physicians, LTD.Group PAC ID 2567411325, 36 clinicians

Ophthalmology Partners, LTD.Group PAC ID 0547392383, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tfountain4298@direct.rush.rush-health.com

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.

• Eye Center Physicians, LTD.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1992715650
  Medicare reassignment Care Compare group NPD
• Ophthalmology Partners, LTD.

  • Ophthalmology Physician
  • Deerfield, IL
  • NPI 1750423463
  Medicare reassignment Care Compare group NPD
• Retina Care, LLC

  • Ophthalmology Physician
  • Skokie, IL
  • NPI 1952793739
  NPD
• University Ophthalmology Associates, LTD

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1689726903
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1033110978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 WAUKEGAN RD",
            "address_2": "SUITE 360",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154374",
            "telephone_number": "847-945-6770",
            "fax_number": "847-945-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 WAUKEGAN RD",
            "address_2": "SUITE 360",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154374",
            "telephone_number": "847-945-6770",
            "fax_number": "847-945-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "TAMARA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-085597",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036085597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085597",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180042658",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Adam Fishbein, PSY.D.
• Michelle Mishler Flowers, M.D.
• Camille Fontenot, RBT
• Gabrielle Fontenot, RBT
• Jeffrey J Foreman, M.D.
• Samantha Fox, PSY.D.
• Jillian Rose Fradin
• Viviene G Francisco, PT
• Grace Francour, LPC, NCC
• Jennifer K. Frank, M.S., L.M.F.T.

• Ophthalmic Plastic and Reconstructive Surgery Physician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.