Individual provider Active NPI

Thomas Leonard Ruiz

  • Optometrist
  • Woodridge, IL
National Provider Identifier
1316597594
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011381 Issued in IL
Practice address
2305 63Rd St
Woodridge, IL 60517-1300
Phone
(630) 463-0990
NPI assigned
Sep 18, 2019
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011381 IL Primary

Addresses

Primary practice location

2305 63Rd St
Woodridge, IL 60517-1300

Mailing address

8569 Sandalwood Dr
Darien, IL 60561-1706
Phone (773) 332-0007

Other practice location 1

13460 S Archer Ave
Lemont, IL 60439-4755
Phone (630) 243-1492

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
I20191112003496 IL Practitioner - Optometry 9436581410 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2305 63Rd St
Woodridge, IL 60517-1300
Phone (630) 463-0990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mint Vision PLLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
In Focus Eyecare P.C. Optometrist CurrentSince Jan 21, 2022 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Oct 14, 2019 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Oct 14, 2019 Accepting new patients

Locations

750 S Randall Rd
Algonquin, IL 60102
Phone (847) 458-5341

5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020

13460 S Archer Ave
Lemont, IL 60439
Phone (630) 243-6518

10550 S Cicero Ave
Oak Lawn, IL 60453
Phone (708) 499-3911

2305 63rd St
Woodridge, IL 60517
Phone (630) 463-0990

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1316597594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8569 SANDALWOOD DR",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605611706",
            "telephone_number": "773-332-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 63RD ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171300",
            "telephone_number": "630-463-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13460 S Archer Ave",
            "address_purpose": "LOCATION",
            "city": "Lemont",
            "state": "IL",
            "postal_code": "604394755",
            "country_code": "US",
            "telephone_number": "630-243-1492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "THOMAS",
        "middle_name": "LEONARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-18",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

Verify at the official NPI Registry.