Individual provider Active NPI

Ronald J Henderson, O.D.

  • Optometrist
  • Northbrook, IL
National Provider Identifier
1063529428
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-007296 Issued in IL
Practice address
1544 Shermer Rd
Northbrook, IL 60062-5347
Phone
(847) 498-4770
Fax
(847) 498-6909
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-007296 IL Primary

Addresses

Primary practice location

1544 Shermer Rd
Northbrook, IL 60062-5347

Mailing address

1544 Shermer Rd
Northbrook, IL 60062-5347
Phone (847) 498-4770

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
I20061211000214 IL Practitioner - Optometry 8224037783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Optometrists, P.C.Group PAC ID 5698774156, 4 clinicians

Practice addresses (Care Compare)

1544 Shermer Rd
Northbrook, IL 60062-5347
Phone (847) 498-4770

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-007296ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Optometrists, P.C. Optometrist CurrentSince Nov 10, 2006 Accepting new patients
The Optometrists, P.C. Optometrist Current Accepting new patients

Locations

510 N Western Ave
Lake Forest, IL 60045
Phone (847) 283-0800

1544 Shermer Rd
Northbrook, IL 60062
Phone (847) 272-3320

1815 Dundee Rd
Northbrook, IL 60062

Organizations & group practices 2

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1063529428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 SHERMER RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625347",
            "telephone_number": "847-498-4770",
            "fax_number": "847-498-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 SHERMER RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625347",
            "telephone_number": "847-498-4770",
            "fax_number": "847-498-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "RONALD",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.