Individual provider Active NPI

Amit Bhambri, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1144517020
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010438 Issued in IL
Practice address
1601 N Harlem Ave
Chicago, IL 60707-4303
Phone
(773) 836-4110
Fax
(773) 637-1109
NPI assigned
Jun 29, 2011
Last updated
Nov 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010438 IL Primary

Addresses

Primary practice location

1601 N Harlem Ave
Chicago, IL 60707-4303

Mailing address

1030 Charlela LN
Apt 202
Elk Grove Village, IL 60007-7249
Phone (773) 354-0239

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
I20111024000415 IL Practitioner - Optometry 8820261670 Reassigns benefits to 2 organizations
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010438ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grayslake Eyecare Assoc LTD Optometrist CurrentSince May 10, 2023 Accepting new patients
Dekalb Eye Consultants, LLC Optometrist PastSince Nov 1, 2023 Accepting new patients

Locations

661 N Lake St
Grayslake, IL 60030
Phone (847) 223-7600

Interoperability endpoints

  • Direct secure messaging: amit.bhambri.p7@direct.hauserross.nextgenshare.com
  • Direct secure messaging: amit.bhambri@uprisedirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1144517020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 CHARLELA LN",
            "address_2": "APT 202",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077249",
            "telephone_number": "773-354-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607074303",
            "telephone_number": "773-836-4110",
            "fax_number": "773-637-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAMBRI",
        "first_name": "AMIT",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.