Individual provider Active NPI

Gregory Lucien Fenton, M.D.

  • Ophthalmology Physician
  • Wheaton, IL
National Provider Identifier
1114136959
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036124435 Issued in IL
Practice address
2015 N Main St
Wheaton, IL 60187-3190
Phone
(630) 668-8250
Fax
(630) 668-8916
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MT185909 PA
Ophthalmology Physician 207W00000X 036124435 IL Primary

Addresses

Primary practice location

2015 N Main St
Wheaton, IL 60187-3190

Mailing address

2015 N Main St
Wheaton, IL 60187-3190
Phone (630) 668-8252

Other identifiers 2

IdentifierTypeStateIssuer
313130004OtherILMEDICARE
036124435MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000966 IL Practitioner - Ophthalmology 6002989845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheaton Eye Clinic LTDGroup PAC ID 2860475944, 44 clinicians

Practice addresses (Care Compare)

2015 N Main St
Wheaton, IL 60187-3152
Phone (630) 668-8250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036124435ILMDOphthalmology Physician
MT185909PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wheaton Eye Clinic LTD Ophthalmology CurrentSince Jul 16, 2010 Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology CurrentSince Jul 16, 2010 Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology Past Accepting new patients

Locations

908 N Elm St
Ste 115
Hinsdale, IL 60521
Phone (630) 668-8250

24024 Brancaster Dr
Naperville, IL 60564
Phone (630) 357-8700

604 Raymond Dr
Naperville, IL 60563
Phone (630) 668-8250

12426 S Van Dyke Rd
Plainfield, IL 60585
Phone (630) 668-8250

2015 N Main St
Wheaton, IL 60187
Phone (630) 665-3690

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1114136959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873190",
            "telephone_number": "630-668-8252",
            "fax_number": "630-668-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873190",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "GREGORY",
        "middle_name": "LUCIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MT185909",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036124435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "313130004",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036124435",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.