Individual provider Active NPI

Thomas M Troutman, OD

  • Optometrist
  • West Dundee, IL
National Provider Identifier
1033155841
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008879 Issued in IL
Practice address
2000 Spring Hill Mall
West Dundee, IL 60118-1270
Phone
(847) 428-9830
Fax
(847) 428-5626
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 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 046008879 IL Primary

Addresses

Primary practice location

2000 Spring Hill Mall
West Dundee, IL 60118-1270

Mailing address

951 Viewpoint Dr
Lake in the Hills, IL 60156-4915
Phone (630) 444-0419

Other identifiers 1

IdentifierTypeStateIssuer
04532290OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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
I20051123000532 IL Practitioner - Optometry 0244250934 Practice locations: Joliet, IL; Orland Park, IL; Vernon Hills, IL
I20150428001417 IN Practitioner - Optometry 0244250934 Practice locations: Merrillville, IN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Hawthorn Ctr
Vernon Hills, IL 60061-1520
Phone (847) 367-0420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046008879ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Usv Optical Inc Past Accepting new patients
Usv Optical Inc Optometrist Past Accepting new patients
Usv Optical Inc. Past Accepting new patients

Organizations & group practices 3

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1033155841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 VIEWPOINT DR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564915",
            "telephone_number": "630-444-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SPRING HILL MALL",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601181270",
            "telephone_number": "847-428-9830",
            "fax_number": "847-428-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTMAN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04532290",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Dundee, IL

Sources for this page

Verify at the official NPI Registry.