Individual provider Active NPI

Scott Michael Amoruso, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1346767027
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011143 Issued in IL
Practice address
2000 N Clybourn Ave # G2
Chicago, IL 60614-4056
Phone
(773) 975-7867
Fax
(773) 975-1972
NPI assigned
Aug 24, 2017
Last updated
Oct 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011143 IL Primary

Addresses

Primary practice location

2000 N Clybourn Ave # G2
Chicago, IL 60614-4056

Mailing address

4835 Saratoga Ave
Downers Grove, IL 60515-3532
Phone (708) 359-9909

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
I20171107001736 IL Practitioner - Optometry 6305102369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1212 N Wells St
Suite 1
Chicago, IL 60610-5962
Phone (312) 664-2020

5408 N Clark St
Chicago, IL 60640-1210
Phone (773) 275-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011143ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Sep 19, 2017 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Sep 19, 2017 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients

Locations

1130 W Madison St
Chicago, IL 60607
Phone (312) 226-7200

1212 N Wells St
Ste 1
Chicago, IL 60610
Phone (312) 664-2020

2000 N Clybourn Ave
#G2
Chicago, IL 60614
Phone (773) 975-7867

321 N Michigan Ave
Chicago, IL 60601
Phone (312) 263-0222

3627 N Western Ave
Chicago, IL 60618
Phone (773) 525-2022

3760 N Broadway St
Chicago, IL 60613
Phone (773) 975-2020

4740 N Lincoln Ave
Chicago, IL 60625
Phone (773) 275-2900

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

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1346767027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 SARATOGA AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153532",
            "telephone_number": "708-359-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N CLYBOURN AVE # G2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144056",
            "telephone_number": "773-975-7867",
            "fax_number": "773-975-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMORUSO",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.