Individual provider Active NPI

Delaram Bahmani, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1356968176
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011444 Issued in IL
Practice address
3500 W Peterson Ave Ste 401
Chicago, IL 60659-3307
Phone
(773) 588-3090
NPI assigned
Jun 27, 2020
Last updated
Mar 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 046011444 IL Primary

Addresses

Primary practice location

3500 W Peterson Ave Ste 401
Chicago, IL 60659-3307

Mailing address

PO Box 463
Mt Prospect, IL 60056-0463

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
I20200805001207 IL Practitioner - Optometry 0446675631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles S Ovitsky PCGroup PAC ID 7012175102, 14 clinicians

Practice addresses (Care Compare)

200 W Northwest Hwy
Suite 104
Mount Prospect, IL 60056-3142
Phone (630) 946-1414

3500 W Peterson Ave
Suite 401
Chicago, IL 60659-3307
Phone (773) 588-3090

Merit-based Incentive Payment System (MIPS)

Final score
97.24 of 100Reported as group
Quality
74.48
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Sight Eyecare LLC Optometrist CurrentSince Nov 28, 2022 Accepting new patients
Charles S Ovitsky PC Optometrist CurrentSince Jul 15, 2020 Accepting new patients

Locations

3500 W Peterson Ave
Ste 401
Chicago, IL 60659

1000 Palm Ave
Mattoon, IL 61938
Phone (217) 234-7403

200 W Northwest Hwy
Ste 104
Mt Prospect, IL 60056
Phone (630) 946-1414

350 W South 1st St
Red Bud, IL 62278
Phone (618) 282-3891

1100 S Lewis Ave
Waukegan, IL 60085
Phone (847) 244-8196

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": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1356968176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600560463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 W PETERSON AVE STE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593307",
            "telephone_number": "773-588-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHMANI",
        "first_name": "DELARAM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-27",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.