Ravi Shukla, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011023 Issued in IL

Practice address

280 Oakbrook Center Mall
Lenscrafters
Oak Brook, IL 60523-1841

Phone

(630) 368-1609

NPI assigned

Jun 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ravi.shukla@uprisedirect.com
• Direct secure messaging: 104220@visionworks.emadirect.md

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.

• Luxottica of America Inc.

  • Point of Service
  • Mason, OH
  • NPI 1831244953

  IL

  Medicare reassignment

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1235580945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 OAKBROOK CENTER MALL",
            "address_2": "LENSCRAFTERS",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 OAKBROOK CENTER MALL",
            "address_2": "LENSCRAFTERS",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231841",
            "telephone_number": "630-368-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "RAVI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandhya Jayaram Shetty, P.T.
• Wilhelmina M Shoger, PHD
• Collin Steele Shotts, PSY.D.
• Shukla Clinical, LLC
• Arvind Shukla, M.B.B.S.
• Jeffery Siddall
• Pamela A Signorella, L AC
• Omayra Silva, APN
• Shawn Singh, DC
• George Edward Sippel

• Optometrist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.