Individual provider Active NPI

David E Cavender, O.D.

  • Optometrist
  • Calumet City, IL
National Provider Identifier
1356413173
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008327 Issued in IL
Practice address
1700 E West Rd
Calumet City, IL 60409-5415
Phone
(708) 891-3330
Fax
(708) 891-0904
NPI assigned
Nov 15, 2006
Last updated
Mar 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008327 IL Primary

Addresses

Primary practice location

1700 E West Rd
Calumet City, IL 60409-5415

Mailing address

1700 E West Rd
Calumet City, IL 60409-5415
Phone (708) 891-3330

Other identifiers 2

IdentifierTypeStateIssuer
046008327MedicaidIL
436350006OtherILMEDICARE PTAN

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
I20100624000831 IL Practitioner - Optometry 1759412406 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046008327ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc CurrentSince Jun 1, 2021 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Jun 1, 2021 Accepting new patients

Locations

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

7208 191st St
Tinley Park, IL 60487
Phone (815) 464-0668

Organizations & group practices 2

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1356413173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E WEST RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095415",
            "telephone_number": "708-891-3330",
            "fax_number": "708-891-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E WEST RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095415",
            "telephone_number": "708-891-3330",
            "fax_number": "708-891-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVENDER",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008327",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "436350006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

Verify at the official NPI Registry.