Individual provider Active NPI

Ryan Le

  • Optometrist
  • Oswego, IL
National Provider Identifier
1043575327
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010573 Issued in IL
Practice address
2300 US Highway 34
Oswego, IL 60543-7132
Phone
(630) 554-5927
NPI assigned
Jul 11, 2012
Last updated
Nov 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010573 IL Primary

Addresses

Primary practice location

2300 US Highway 34
Oswego, IL 60543-7132

Mailing address

1520 Fringetree LN
Woodridge, IL 60517-4653
Phone (708) 275-6247

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
I20130416000629 IL Practitioner - Optometry 7810133949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2300 US Hwy 34
Oswego, IL 60543-7132
Phone (630) 554-5927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ryan Le and Associates LLC Optometrist CurrentSince Dec 5, 2012 Accepting new patients

Locations

2300 US Highway 34
Oswego, IL 60543
Phone (630) 554-5616

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700265600000",
    "number": "1043575327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 FRINGETREE LN",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605174653",
            "telephone_number": "708-275-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 US HIGHWAY 34",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437132",
            "telephone_number": "630-554-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

Verify at the official NPI Registry.