Faye Therese Gamboa, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010799 Issued in IL

Practice address

1745 Orchard LN
Northfield, IL 60093-3432

Phone

(847) 787-1187

Fax

(847) 789-7181

NPI assigned

Jun 30, 2014

Sex

Female

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

Specialty

Optometry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wanderlust Eyecare, P.C.

  • Optometrist
  • Northfield, IL
  • NPI 1760971220
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1275948044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 ORCHARD LN",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933432",
            "telephone_number": "847-787-1187",
            "fax_number": "847-789-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 ORCHARD LN",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933432",
            "telephone_number": "847-787-1187",
            "fax_number": "847-789-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "FAYE THERESE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Fruel
• Agathe Ann Gabriel, LCSW
• Sharyn Galindo, NBC-HWC
• Elizabeth Geen Gallagher
• Vanessa Galvan
• Sam Gao, LMT
• Bozena Garvey, MA
• Meredith Gentry
• Anthony James Geroulis, M.D.
• William David Gieseke, PH.D.

• Optometrist in Northfield, IL
• Providers in Northfield, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.