Individual provider Active NPI

Poonam Patel, O.D.

  • Optometrist
  • Schaumburg, IL
National Provider Identifier
1295022127
Registry record updated Mar 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010453 Issued in IL
Practice address
850 E Golf Rd
Schaumburg, IL 60173-4502
Phone
(847) 519-1020
Fax
(847) 519-0626
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004691 MI
Optometrist 152W00000X 046010453 IL Primary

Addresses

Primary practice location

850 E Golf Rd
Schaumburg, IL 60173-4502

Mailing address

903 Christa CT
Elk Grove Village, IL 60007-3079
Phone (847) 912-5288

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111019000961 IL Practitioner - Optometry 5597937300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Point Optical Group 28 clinicians

Practice addresses (Care Compare)

850 E Golf Rd
Schaumburg, IL 60173-4502
Phone (847) 519-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010453ILMDOptometrist
4901004691MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Point Optical Group Optometrist CurrentSince Feb 1, 2024 Accepting new patients

Locations

900 Belvidere Rd
Belvidere, IL 61008
Phone (708) 859-8000

6150 E State St
Ste 130
Rockford, IL 61108
Phone (708) 859-8000

850 E Golf Rd
Schaumburg, IL 60173
Phone (847) 519-1020

246 Hawthorn Village Cmn
Vernon Hills, IL 60061
Phone (847) 680-9160

316 S Hamilton Rd
Gahanna, OH 43230

Organizations & group practices 1

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709424000000",
    "number": "1295022127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 CHRISTA CT",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073079",
            "telephone_number": "847-912-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E GOLF RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734502",
            "telephone_number": "847-519-1020",
            "fax_number": "847-519-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POONAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004691",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.