Individual provider Active NPI

Stephanie Lynn Adams, OD, PHD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1245721679
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011296 Issued in IL
Practice address
3241 S Michigan Ave
Chicago, IL 60616-4201
Phone
(312) 949-7751
NPI assigned
May 22, 2018
Last updated
May 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 046011296 IL Primary

Addresses

Primary practice location

3241 S Michigan Ave
Chicago, IL 60616-4201

Mailing address

790 Hyde Park Ave Apt 37
Boston, MA 02136-2223

Other practice location 1

1400 Vfw Pkwy
West Roxbury, MA 02132-4927
Phone (617) 323-7700

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230501002320 WA Practitioner - Optometry 0840523080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

314 E McLoughlin Blvd
Vancouver, WA 98663-3371
Phone (360) 694-8303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vancouver Contact Lens & Vision Clinic Inc Optometrist CurrentSince Jan 26, 2023 Accepting new patients
Vancouver Contact Lens & Vision Clinic Inc Optometrist CurrentSince Jan 26, 2023 Accepting new patients

Locations

329 NE 6th Ave
Camas, WA 98607
Phone (360) 834-4802

314 E McLoughlin Blvd
Vancouver, WA 98663
Phone (360) 694-8303

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1245721679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 HYDE PARK AVE APT 37",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021362223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164201",
            "telephone_number": "312-949-7751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Vfw Pkwy",
            "address_purpose": "LOCATION",
            "city": "West Roxbury",
            "state": "MA",
            "postal_code": "021324927",
            "country_code": "US",
            "telephone_number": "617-323-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.