NPIMap

Individual provider Active NPI

Michael J. Shapiro, MD

  • Retina Specialist (Ophthalmology) Physician
  • Des Plaines, IL
National Provider Identifier
1235238973
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
036070891 Issued in IL
Practice address
2454 E Dempster St
Suite 400
Des Plaines, IL 60016-5315
Phone
(847) 299-0700
Fax
(847) 390-0616
NPI assigned
Sep 21, 2006
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 36070891 IL
Retina Specialist (Ophthalmology) Physician 207WX0107X 036070891 IL Primary

Addresses

Primary practice location

2454 E Dempster St
Suite 400
Des Plaines, IL 60016-5315

Mailing address

2454 E Dempster St
Ste 400
Des Plaines, IL 60016-5320
Phone (847) 299-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070123000302 IL Practitioner - Ophthalmology 4486655131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Consultants, LTDGroup PAC ID 4486633922, 11 clinicians

Practice addresses (Care Compare)

2454 E Dempster St
Suite 400
Des Plaines, IL 60016-5320
Phone (847) 299-0700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36070891ILMDOphthalmology Physician
036070891ILMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Consultants, LTD CurrentSince Jan 4, 2007 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 10, 2015 Accepting new patients
Cook County CurrentSince Nov 10, 2015 Accepting new patients
The Board of Trustees of the University of Illinois PastSince Apr 6, 2023 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

2454 E Dempster St
Ste 400
Des Plaines, IL 60016
Phone (847) 299-0700

755 S Milwaukee Ave
Ste 263
Libertyville, IL 60048
Phone (847) 299-0700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCEACA/Endpoint/FCEACA

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1235238973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 E DEMPSTER ST",
            "address_2": "STE 400",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165320",
            "telephone_number": "847-299-0700",
            "fax_number": "847-390-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 E DEMPSTER ST",
            "address_2": "SUITE 400",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165315",
            "telephone_number": "847-299-0700",
            "fax_number": "847-390-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "36070891",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036070891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.