Individual provider Active NPI

Bradley V. Kampschroeder, O.D.

  • Optometrist
  • Naperville, IL
National Provider Identifier
1104919158
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46-8724 Issued in IL
Practice address
29 S Webster St
Suite 200
Naperville, IL 60540-5356
Phone
(630) 357-3511
Fax
(630) 357-0556
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 46-8724 IL Primary

Addresses

Primary practice location

29 S Webster St
Suite 200
Naperville, IL 60540-5356

Mailing address

29 S Webster St
Suite 200
Naperville, IL 60540-5356
Phone (630) 357-3511

Other practice location 1

5018 Fairview Ave
Downers Grove, IL 60515-3951
Phone (630) 969-3268

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
I20040817000473 IL Practitioner - Optometry 2961484332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naper Grove Vision Care, P.C.Group PAC ID 4082696448, 10 clinicians

Practice addresses (Care Compare)

29 S Webster St
Suite 200
Naperville, IL 60540-5368
Phone (630) 357-3511

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46-8724ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Naper Grove Vision Care, P.C. Optometrist CurrentSince Sep 1, 2004 Accepting new patients
Naper Grove Vision Care, P.C. CurrentSince Sep 1, 2004 Accepting new patients

Locations

6840 Main St
Ste 250
Downers Grove, IL 60516
Phone (630) 969-3268

5018 Fairview Ave
Downers Grove, IL 60515
Phone (630) 357-3511

29 S Webster St
Ste 200
Naperville, IL 60540
Phone (630) 357-3511

1331 W 75th St
Ste 403
Naperville, IL 60540
Phone (630) 357-3511

Interoperability endpoints

  • Direct secure messaging: direct@napergrovevisioncarenapervilleil.compulinkdirect.com

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104919158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST",
            "address_2": "SUITE 200",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405356",
            "telephone_number": "630-357-3511",
            "fax_number": "630-357-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST",
            "address_2": "SUITE 200",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405356",
            "telephone_number": "630-357-3511",
            "fax_number": "630-357-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5018 Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605153951",
            "country_code": "US",
            "telephone_number": "630-969-3268",
            "fax_number": "630-969-3709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMPSCHROEDER",
        "first_name": "BRADLEY",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46-8724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.