Individual provider Active NPI

Gina Marie Piper, O.D.

  • Optometrist
  • Evanston, IL
National Provider Identifier
1043220783
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008974 Issued in IL
Practice address
522 Dempster Ave.
Evanston, IL 60202
Phone
(847) 864-5200
Fax
(847) 864-1231
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-008974 IL Primary

Addresses

Primary practice location

522 Dempster Ave.
Evanston, IL 60202

Mailing address

676 N Saint Clair St
Ste 1500
Chicago, IL 60611-2995
Phone (847) 864-5200

Other identifiers 5

IdentifierTypeStateIssuer
210209OtherMEDICARE GROUP
046008974MedicaidIL
7235044OtherAETNA
1636706OtherBCBS
8825444OtherILMULTIPLAN

Other names 1

  • Dr. Gina Marie Bulf Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008974ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Eye Specialists LTD Optometrist PastSince Jan 6, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1043220783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "address_2": "STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112995",
            "telephone_number": "847-864-5200",
            "fax_number": "847-864-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 DEMPSTER AVE.",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60202",
            "telephone_number": "847-864-5200",
            "fax_number": "847-864-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPER",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "210209",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008974",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7235044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1636706",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "8825444",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "BULF",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.