Individual provider Active NPI

Richard M Ahuja, MD

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1346293438
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036102643 Issued in IL
Practice address
840 W Irving Park Rd
Suite 401
Chicago, IL 60613-3011
Phone
(773) 975-6868
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036102643 IL Primary

Addresses

Primary practice location

840 W Irving Park Rd
Suite 401
Chicago, IL 60613-3011

Mailing address

PO Box 10616
Chicago, IL 60610-0616

Other identifiers 1

IdentifierTypeStateIssuer
036102643MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621002359 TN Practitioner - Ophthalmology 1254406366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rush Medical College of Rush University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Shore Retina, SC CorpGroup PAC ID 3072056894, 2 clinicians

Practice addresses (Care Compare)

1208 Gay St
Dandridge, TN 37725-4720
Phone (865) 484-9948

PO Box
Suite 1751
Dandridge, TN 37725

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Shore Retina, S.C. Corp Ophthalmology CurrentSince Jan 1, 2024 Accepting new patients

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

840 W Irving Park Rd
Ste 401
Chicago, IL 60613
Phone (773) 472-3937

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1346293438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10616",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606100616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W IRVING PARK RD",
            "address_2": "SUITE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133011",
            "telephone_number": "773-975-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHUJA",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036102643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102643",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.