Individual provider Active NPI

Aruna Rajagopalan, O.D, M.S

  • Optometrist
  • Palatine, IL
National Provider Identifier
1114105053
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
484 W Parkside Dr
Palatine, IL 60067-9007
Phone
(847) 963-9631
NPI assigned
Feb 1, 2008
Last updated
Feb 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

484 W Parkside Dr
Palatine, IL 60067-9007

Mailing address

484 W Parkside Dr
Palatine, IL 60067-9007
Phone (847) 963-9631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160427001912 CA Practitioner - Optometry 2365752797 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
046010047ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Mar 24, 2016 Accepting new patients
County of San Mateo CurrentSince Aug 1, 2017 Accepting new patients
County of San Mateo CurrentSince Mar 24, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Mar 24, 2016 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 7

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": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1114105053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 W PARKSIDE DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600679007",
            "telephone_number": "847-963-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 W PARKSIDE DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600679007",
            "telephone_number": "847-963-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAGOPALAN",
        "first_name": "ARUNA",
        "name_prefix": "Dr.",
        "credential": "O.D, M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

Verify at the official NPI Registry.