Individual provider Active NPI

Douglas Aaron Yuvan, O.D.

  • Optometrist
  • Saint Charles, IL
National Provider Identifier
1043234263
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46-009204 Issued in IL
Practice address
1001 E Main St
#C
Saint Charles, IL 60174-2202
Phone
(630) 584-1111
Fax
(630) 584-1239
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 46-009204 IL Primary

Addresses

Primary practice location

1001 E Main St
#C
Saint Charles, IL 60174-2202

Mailing address

1001 E Main St
#C
Saint Charles, IL 60174-2202
Phone (630) 584-1111

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
I20051111000043 IL Practitioner - Optometry 8022087162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Ridge Vision Care, LTDGroup PAC ID 0042289183, 4 clinicians

Practice addresses (Care Compare)

1001 E Main St
Suite C
St Charles, IL 60174-2203
Phone (630) 584-1111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46-009204ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Ridge Vision Care, LTD. Optometrist CurrentSince Nov 26, 1999 Accepting new patients
Richard F Butz Past Accepting new patients
Oswego Vision, LTD Optometrist PastSince Dec 1, 2005 Accepting new patients

Locations

1001 E Main St
Ste C
St Charles, IL 60174
Phone (630) 584-1111

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043234263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E MAIN ST",
            "address_2": "#C",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742202",
            "telephone_number": "630-584-1111",
            "fax_number": "630-584-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E MAIN ST",
            "address_2": "#C",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742202",
            "telephone_number": "630-584-1111",
            "fax_number": "630-584-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUVAN",
        "first_name": "DOUGLAS",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46-009204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, IL

Sources for this page

Verify at the official NPI Registry.