Individual provider Active NPI

Richard Scott Newcomb

  • Optometrist
  • Roscoe, IL
National Provider Identifier
1396885794
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007735 Issued in IL
Practice address
11710 Main St Suite 2
Roscoe, IL 61073
Phone
(815) 623-6060
Fax
(815) 623-6969
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046007735 IL Primary

Addresses

Primary practice location

11710 Main St Suite 2
Roscoe, IL 61073

Mailing address

11710 Main St Suite 2
Roscoe, IL 61073
Phone (815) 623-6060

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
I20040115000244 IL Practitioner - Optometry 2860393725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11710 Main St
Suite 2
Roscoe, IL 61073-9566
Phone (815) 623-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Center of Loves Park, Inc. Optometrist CurrentSince Jan 2, 1966 Accepting new patients
Vision Center of Loves Park, Inc. Optometrist CurrentSince Jan 2, 1966 Accepting new patients

Locations

5020 N 2nd St
Loves Park, IL 61111
Phone (815) 282-3468

11710 Main St
Ste 2
Roscoe, IL 61073
Phone (815) 623-6060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1396885794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 MAIN ST SUITE 2",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "61073",
            "telephone_number": "815-623-6060",
            "fax_number": "815-623-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 MAIN ST SUITE 2",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "61073",
            "telephone_number": "815-623-6060",
            "fax_number": "815-623-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "RICHARD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roscoe, IL

Sources for this page

Verify at the official NPI Registry.