Jirasan Sakulsom, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010489 Issued in IL

Practice address

2210 N Clark St
Chicago, IL 60614-3855

Phone

(773) 697-9100

NPI assigned

Aug 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• 95TH Vision Center LLC

  dba Pearle Vision

  • Optometrist
  • Evergreen Park, IL
  • NPI 1487203980
  NPD (past)
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)
• Gel M Gowin,Inc.

  • Eyewear Supplier
  • Evergreen Park, IL
  • NPI 1225351471
  NPD (past)
• Vision Clinic Dr. Savin & Associates

  • Optometrist
  • Racine, WI
  • NPI 1518949056
  NPD (past)
• Vision Therapy Center of Wisconsin, LLC

  • Vision Therapy Optometrist
  • Racine, WI
  • NPI 1053842419
  NPD (past)

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1215120522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "address_2": "SUITE 20-220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143855",
            "telephone_number": "773-697-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "259 E Erie St",
            "address_2": "Suite 20-220",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-695-8150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAKULSOM",
        "first_name": "JIRASAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010489",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Franklin B Saksena, M.D.
• Sanjana Saksena
• Meera Sakthivel, MD
• Robert Sakulanda, M.D.
• Somchart Sakulkoo, BCBA
• Atsushi Sakuraba, MD
• Sal Child Services Inc.
• Marc Andrew Sala, MD
• Salaam Community Wellness Center
• Salaam Consultant and Reentry Firm LLC

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.