Individual provider Active NPI

Tiffany M Andrzejewski, OD

  • Corneal and Contact Management Optometrist
  • Highland Park, IL
National Provider Identifier
1174836548
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
046010521 Issued in IL
Practice address
806 Central Ave
Suite 300
Highland Park, IL 60035-5613
Phone
(847) 432-6010
Fax
(847) 432-8241
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 046010521 IL Primary

Addresses

Primary practice location

806 Central Ave
Suite 300
Highland Park, IL 60035-5613

Mailing address

806 Central Ave
Suite 300
Highland Park, IL 60035-5613
Phone (847) 432-6010

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
I20120214000905 IL Practitioner - Optometry 5890988679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Cornea Consultants LTDGroup PAC ID 6608771324, 10 clinicians

Practice addresses (Care Compare)

1585 N Barrington Rd
Suite 502
Hoffman Estates, IL 60169-5020
Phone (847) 255-3515

1725 W Harrison St
Suite 928
Chicago, IL 60612-3845
Phone (847) 255-3515

806 Central Ave
Suite 300
Highland Park, IL 60035-5613
Phone (847) 255-3515

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
91.74
Improvement activities
40
Cost
77.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010521ILMDCorneal and Contact Management Optometrist

Interoperability endpoints

  • Direct secure messaging: tandrzejewski@cccltd.intellechartdirect.net

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": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1174836548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 CENTRAL AVE",
            "address_2": "SUITE 300",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355613",
            "telephone_number": "847-432-6010",
            "fax_number": "847-432-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 CENTRAL AVE",
            "address_2": "SUITE 300",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355613",
            "telephone_number": "847-432-6010",
            "fax_number": "847-432-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRZEJEWSKI",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046010521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.