Organization Active NPI

Associated Ophthalmologists S C

  • Ophthalmology Physician
  • Joliet, IL
National Provider Identifier
1225148448
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
042001040 Issued in IL
Legal business name
ASSOCIATED OPHTHALMOLOGISTS S C
Practice address
219 N Hammes Ave
Joliet, IL 60435-8145
Phone
(815) 741-3220
Fax
(815) 741-3814
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. David D. Morimoto, M.D.NPI 1356305643
Title
Partner
Phone
(815) 741-3220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 042001040 IL Primary

Addresses

Primary practice location

219 N Hammes Ave
Joliet, IL 60435-8145

Mailing address

219 N Hammes Ave
Joliet, IL 60435-8145
Phone (815) 741-3220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100512000537 IL Part B Supplier - Clinic/Group Practice 8022146091 Receives reassigned benefits from 3 practitioners
Practice locations: Joliet, IL

National Provider Directory

National Provider Directory

Locations

219 N Hammes Ave
Joliet, IL 60435
Phone (815) 741-0095

219 N Hammes Ave
Ste 1
Joliet, IL 60435

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1225148448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358145",
            "telephone_number": "815-741-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358145",
            "telephone_number": "815-741-3220",
            "fax_number": "815-741-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED OPHTHALMOLOGISTS S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "MORIMOTO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "815-741-3220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "042001040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.