Individual provider Active NPI

Niki Mehta, OD

  • Optometrist
  • Oakbrook Terrace, IL
National Provider Identifier
1407474166
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011452 Issued in IL
Practice address
17W410 22ND St
Oakbrook Terrace, IL 60181-4401
Phone
(630) 530-2020
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011452 IL Primary

Addresses

Primary practice location

17W410 22ND St
Oakbrook Terrace, IL 60181-4401

Mailing address

17W410 22ND St
Oakbrook Terrace, IL 60181-4401
Phone (630) 530-2020

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
I20201005000149 IL Practitioner - Optometry 8224452289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

611 Meacham Rd
Elk Grove Village, IL 60007-3020
Phone (847) 584-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Zurich Optical Care LLC Optometrist CurrentSince Mar 5, 2023 Accepting new patients
Christina J. Levi O D P C Optometrist CurrentSince Apr 14, 2022 Accepting new patients
Christina J. Levi O D P C Optometrist Past Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

2100 Troy Rd
Edwardsville, IL 62025
Phone (618) 656-8888

611 Meacham Rd
Elk Grove Village, IL 60007
Phone (847) 584-9900

664 S Rand Rd
Lake Zurich, IL 60047
Phone (847) 540-7737

Organizations & group practices 4

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": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1407474166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17W410 22ND ST",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814401",
            "telephone_number": "630-530-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W410 22ND ST",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814401",
            "telephone_number": "630-530-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "NIKI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.