Individual provider Active NPI

Michelle E Andreoli, MD

  • Ophthalmology Physician
  • Naperville, IL
National Provider Identifier
1437350212
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036118288 Issued in IL
Practice address
636 Raymond Dr Ste 300
Naperville, IL 60563-9792
Phone
(331) 732-4370
Fax
(331) 732-4375
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036118288 IL Primary

Addresses

Primary practice location

636 Raymond Dr Ste 300
Naperville, IL 60563-9792

Mailing address

636 Raymond Dr Ste 300
Naperville, IL 60563-9792
Phone (331) 732-4370

Other identifiers 2

IdentifierTypeStateIssuer
P00435441OtherILRAILROAD MEDICARE
036118288MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070705000404 IL Practitioner - Ophthalmology 3971603077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Boston University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036118288ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jul 19, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 19, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

308 Randall Rd
Ste C
Geneva, IL 60134
Phone (331) 732-4370

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

636 Raymond Dr
Ste 107
Naperville, IL 60563
Phone (630) 359-8396

636 Raymond Dr
Ste 300
Naperville, IL 60563
Phone (331) 732-4370

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1437350212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639792",
            "telephone_number": "331-732-4370",
            "fax_number": "331-732-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR STE 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639792",
            "telephone_number": "331-732-4370",
            "fax_number": "331-732-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREOLI",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036118288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00435441",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118288",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.