Individual provider Active NPI

Tafadzwa Makoni, O.D

  • Optometrist
  • South Elgin, IL
National Provider Identifier
1114215530
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010486 Issued in IL
Practice address
530 Randall Rd
South Elgin, IL 60177-3315
Phone
(847) 668-7365
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010486 IL Primary

Addresses

Primary practice location

530 Randall Rd
South Elgin, IL 60177-3315

Mailing address

11000 Bayou CT
Huntley, IL 60142-8186

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
I20120123000668 IL Practitioner - Optometry 4789851379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1520 Carlemont Dr
Suite L
Crystal Lake, IL 60014-1836
Phone (815) 420-5000

530 Randall Rd
South Elgin, IL 60177-3358
Phone (847) 697-1242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010486ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Eyecare Services, LLC Optometrist CurrentSince Dec 8, 2011 Accepting new patients

Locations

1520 Carlemont Dr
Ste L
Crystal Lake, IL 60014
Phone (815) 420-5000

530 Randall Rd
South Elgin, IL 60177
Phone (847) 697-1017

Organizations & group practices 1

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1114215530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 BAYOU CT",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601428186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 RANDALL RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773315",
            "telephone_number": "847-668-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKONI",
        "first_name": "TAFADZWA",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

Verify at the official NPI Registry.