NPIMap

Organization Active NPI

University Ophthalmology Associates, LTD

  • Ophthalmology Physician
  • Skokie, IL
National Provider Identifier
1245382126
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
UNIVERSITY OPHTHALMOLOGY ASSOCIATES, LTD
Practice address
9700 Kenton Ave
Suite K204
Skokie, IL 60076-1259
Phone
(947) 677-8989
Fax
(847) 677-9008
NPI assigned
Jan 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert M Stein, M.D.NPI 1174675862
Title
Partner
Phone
(847) 677-8989

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 MULTIPLE SINGLE SPECIALTY GROUP 207W00000X IL Primary

Addresses

Primary practice location

9700 Kenton Ave
Suite K204
Skokie, IL 60076-1259

Mailing address

9700 Kenton Ave
Suite K204
Skokie, IL 60076-1259
Phone (947) 677-8989

Other identifiers 1

IdentifierTypeStateIssuer
1608654OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070925000189 IL Part B Supplier - Clinic/Group Practice 4284728007 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Skokie, IL; Chicago, IL; Libertyville, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
University Ophthalmology ASC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245382126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 KENTON AVE",
            "address_2": "SUITE K204",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761259",
            "telephone_number": "947-677-8989",
            "fax_number": "847-677-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 KENTON AVE",
            "address_2": "SUITE K204",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761259",
            "telephone_number": "947-677-8989",
            "fax_number": "847-677-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OPHTHALMOLOGY ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "847-677-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1608654",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.