Andrea Johnson-Grote, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

IL046009124 Issued in IL

Practice address

3136 N Lincoln Ave
Chicago, IL 60657-3117

Phone

(773) 871-8210

Fax

(773) 871-4290

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Andrea Johnson Former name

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoreland Optical Co 27 IncGroup PAC ID 6305168469, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shoreland Optical Co #27 Inc.

  • Optometrist
  • Chicago, IL
  • NPI 1508986175
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1447370077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 FAIR OAKS AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021336",
            "telephone_number": "773-727-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573117",
            "telephone_number": "773-871-8210",
            "fax_number": "773-871-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-GROTE",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "IL046009124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JOHNSON",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brianna Johnson Williams
• Kimberly Sue Johnson-Borgman, MS SLP CCC
• Sherron R Johnson-Boyd, RN
• Kimberly Leona Johnson-Davis, MD
• Latoya Johnson-Foster, LPC
• Kelly Shavonne Johnson-Means, OTR/L
• Leigh Johnson-Migalski, PSYD
• Tanya A Johnson-Ramey
• Ericka S Johnson-White, ,MSW, LSW
• Aaron Johnson

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.