Individual provider Active NPI

Peter Joseph Gunther, O.D.

  • Optometrist
  • Rockford, IL
National Provider Identifier
1073597498
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011151 Issued in IL
Practice address
2995 Eastrock Dr
Rockford, IL 61109
Phone
(815) 316-3735
NPI assigned
Nov 30, 2005
Last updated
May 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD0000002583 TN
Optometrist 152W00000X 0618001169 VA
Optometrist 152W00000X TA1728 MD
Optometrist 152W00000X 046011151 IL Primary

Addresses

Primary practice location

2995 Eastrock Dr
Rockford, IL 61109

Mailing address

2995 Eastrock Dr
Rockford, IL 61109-1737
Phone (815) 316-3735

Other practice location 1

2995 Eastrock Dr
Rockford, IL 61109-1737
Phone (815) 316-3735

Other practice location 2

2995 Eastrock Dr
Rockford, IL 61109
Phone (815) 316-3735

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
I20171121001098 IL Practitioner - Optometry 8921091125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirk Eye Center SCGroup PAC ID 2769527118, 8 clinicians

Practice addresses (Care Compare)

3477 Grand Ave
Gurnee, IL 60031-3734
Phone (847) 249-4660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011151ILMDOptometrist
TA1728MDMDOptometrist
OD0000002583TNMDOptometrist
0618001169VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
River Forest Surgery Center LLC Current Accepting new patients
River Forest Surgery Center LLC Current Accepting new patients
Kirk Eye Center, SC CurrentSince Mar 1, 2023 Accepting new patients
Eye Associates Optometrist Past Accepting new patients
Clear Vision Eyecare LLC Optometrist PastSince Jul 21, 2017 Accepting new patients
Miller Eye Center LTD PastSince Jul 1, 2019 Accepting new patients

Locations

3477 Grand Ave
Gurnee, IL 60031
Phone (847) 249-4660

7427 Lake St
River Forest, IL 60305
Phone (708) 488-1200

Interoperability endpoints

  • Direct secure messaging: pgunther@kirkeye.imwdirect.com
  • Direct secure messaging: pgunther@millereye.intellechartdirect.net

Organizations & group practices 6

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1073597498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 EASTROCK DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611091737",
            "telephone_number": "815-316-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 EASTROCK DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61109",
            "telephone_number": "815-316-3735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2995 Eastrock Dr",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611091737",
            "country_code": "US",
            "telephone_number": "815-316-3735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2995 Eastrock Dr",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "61109",
            "country_code": "US",
            "telephone_number": "815-316-3735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNTHER",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000002583",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001169",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1728",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.