Individual provider Active NPI

Christopher John Staron, OD

  • Optometrist
  • Bloomingdale, IL
National Provider Identifier
1467589655
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
505 W Army Trail Road
Bloomingdale, IL 60108
Phone
(630) 351-3078
Fax
(630) 351-3137
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

505 W Army Trail Road
Bloomingdale, IL 60108

Mailing address

6537 Midhurst Road
Downers Grove, IL 60516
Phone (630) 802-5192

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
I20090729000474 IL Practitioner - Optometry 6901959584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

505 W Army Trail Rd
Bloomingdale, IL 60108-1391
Phone (630) 351-3078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Eyecare Associates, Inc Optometrist CurrentSince Apr 7, 2009 Accepting new patients

Locations

505 W Army Trail Rd
Bloomingdale, IL 60108
Phone (630) 351-3037

Organizations & group practices 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467589655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6537 MIDHURST ROAD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60516",
            "telephone_number": "630-802-5192",
            "fax_number": "630-351-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W ARMY TRAIL ROAD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "630-351-3078",
            "fax_number": "630-351-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARON",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.