Individual provider Active NPI

Murry S Gussis, O.D.

  • Optometrist
  • Carpentersville, IL
National Provider Identifier
1033371869
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006970 Issued in IL
Practice address
365 Lake Marian Rd
Carpentersville, IL 60110-2096
Phone
(847) 426-5251
NPI assigned
Jul 2, 2008
Last updated
Jun 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046006970 IL Primary

Addresses

Primary practice location

365 Lake Marian Rd
Carpentersville, IL 60110-2096

Mailing address

313 S 3Rd St
West Dundee, IL 60118-2225
Phone (224) 699-9252

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
I20180716001228 IL Practitioner - Optometry 8123375656 Practice locations: Carpentersville, IL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

365 Lake Marian Rd
Carpentersville, IL 60110-2096
Phone (847) 426-5251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046006970ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Z Gussis, Apn PastSince Sep 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1033371869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 S 3RD ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182225",
            "telephone_number": "224-699-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 LAKE MARIAN RD",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601102096",
            "telephone_number": "847-426-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSSIS",
        "first_name": "MURRY",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carpentersville, IL

Sources for this page

Verify at the official NPI Registry.