Active NPI
Poonam Patel, O.D.
- Optometrist
- Schaumburg, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010453
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 046010453 | IL | MD | Optometrist |
| 4901004691 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Point Optical Group | Optometrist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2024; 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.