Organization Active NPI

DRS. Leahy & Disalvo-Ost, P.C.

  • Optometrist
  • Oak Lawn, IL
National Provider Identifier
1093851487
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
060.003768 Issued in IL
Legal business name
DRS. LEAHY & DISALVO-OST, P.C.
Practice address
4445 W 95TH St
Oak Lawn, IL 60453-7219
Phone
(708) 425-6500
Fax
(708) 425-1455
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Margaret E. Pawelski
Title
Manager
Phone
(708) 425-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 060.003768 IL Primary

Addresses

Primary practice location

4445 W 95TH St
Oak Lawn, IL 60453-7219

Mailing address

4445 W 95TH St
Oak Lawn, IL 60453-7219
Phone (708) 425-6500

Other identifiers 1

IdentifierTypeStateIssuer
CN3870OtherILRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070328000358 IL Part B Supplier - Clinic/Group Practice 3678677895 Receives reassigned benefits from 5 practitioners
Practice locations: Oak Lawn, IL
O20110203001155 IL DME Supplier - Physician - Optometrist 3678677895 Practice locations: Oaklawn, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
DRS Van Lente & Leahy PC4445 W 95TH Street, Oaklawn, IL 60453(708) 425-6500 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1995

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1093851487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537219",
            "telephone_number": "708-425-6500",
            "fax_number": "708-425-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537219",
            "telephone_number": "708-425-6500",
            "fax_number": "708-425-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. LEAHY & DISALVO-OST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "PAWELSKI",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-425-6500"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "060.003768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN3870",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.