Individual provider Active NPI

Galina Nikolova

  • Optometrist
  • Bensenville, IL
National Provider Identifier
1386267045
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011408 Issued in IL
Practice address
117 W Main St
Bensenville, IL 60106-2133
Phone
(630) 860-5066
NPI assigned
May 28, 2020
Last updated
May 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011408 IL Primary

Addresses

Primary practice location

117 W Main St
Bensenville, IL 60106-2133

Mailing address

441 Dorothy Dr
Des Plaines, IL 60016-5711
Phone (847) 693-1327

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
I20200921002834 IL Practitioner - Optometry 1153749254 Reassigns benefits to 1 organization

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
Naper Grove Vision Care, P.C.Group PAC ID 4082696448, 10 clinicians

Practice addresses (Care Compare)

1331 W 75TH St
Suite 403
Naperville, IL 60540-9311
Phone (630) 357-3511

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011408ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Naper Grove Vision Care, P.C. CurrentSince Nov 30, 2020 Accepting new patients
Naper Grove Vision Care, P.C. Optometrist CurrentSince Nov 30, 2020 Accepting new patients

Locations

6840 Main St
Ste 250
Downers Grove, IL 60516
Phone (630) 969-3268

1331 W 75th St
Ste 403
Naperville, IL 60540
Phone (630) 357-3511

29 S Webster St
Ste 200
Naperville, IL 60540
Phone (630) 357-3511

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1386267045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 DOROTHY DR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165711",
            "telephone_number": "847-693-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W MAIN ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062133",
            "telephone_number": "630-860-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLOVA",
        "first_name": "GALINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensenville, IL

Sources for this page

Verify at the official NPI Registry.