Individual provider Active NPI

Shreya N. Patel, O.D.

  • Optometrist
  • Elk Grove Village, IL
National Provider Identifier
1285896324
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010066 Issued in IL
Practice address
801 Meacham Rd
Elk Grove Village, IL 60007-3073
Phone
(847) 584-7090
NPI assigned
Jun 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010066 IL Primary

Addresses

Primary practice location

801 Meacham Rd
Elk Grove Village, IL 60007-3073

Mailing address

801 Meacham Rd
Elk Grove Village, IL 60007-3073
Phone (847) 584-7090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140702001055 IN Practitioner - Optometry 2466582473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Eye Care IncGroup PAC ID 9830169234, 33 clinicians

Practice addresses (Care Compare)

449 E Summit St
Eagle Eye Optique
Crown Point, IN 46307-3539
Phone (219) 662-1600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010066ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Eye Care Inc Optometrist CurrentSince Mar 31, 2021 Accepting new patients
Diane Lis O.D.S.C. Optometrist Past Accepting new patients
Duane a Gillam Optometrist Past Accepting new patients

Locations

449 E Summit St
Ste A
Crown Point, IN 46307
Phone (219) 662-1600

449 E Summit St
Crown Point, IN 46307
Phone (219) 662-1600

1221 S Creasy Ln
Ste A
Lafayette, IN 47905
Phone (765) 447-4951

3526 Osborne Ln
Lafayette, IN 47909
Phone (765) 447-4951

Interoperability endpoints

  • Direct secure messaging: shreya.patel@direct.revolutionehr.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1285896324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MEACHAM RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073073",
            "telephone_number": "847-584-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEACHAM RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073073",
            "telephone_number": "847-584-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHREYA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.