Individual provider Active NPI

Maria C Rodriguez, OD

  • Optometrist
  • Berwyn, IL
National Provider Identifier
1477273449
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011685 Issued in IL
Practice address
7153 Cermak Rd
Berwyn, IL 60402-2134
Phone
(708) 795-8585
NPI assigned
Aug 31, 2022
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 046011685 IL
Pediatric Optometrist 152WP0200X 046011685 IL
Optometrist 152W00000X 046011685 IL Primary

Addresses

Primary practice location

7153 Cermak Rd
Berwyn, IL 60402-2134

Mailing address

1507 Oak Park Ave
Berwyn, IL 60402-1340
Phone (773) 600-1443

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
I20230906002974 IL Practitioner - Optometry 4183088396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2022
Medicare assignment
May accept Medicare assignment
Group practices
In Focus Eyecare PCGroup PAC ID 0143520122, 6 clinicians

Practice addresses (Care Compare)

13460 S Archer Ave
Lemont, IL 60439-4755
Phone (847) 458-5343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
In Focus Eyecare P.C. Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Luxottica of America Inc. PastSince Sep 4, 2022 Accepting new patients
Luxottica of America Inc PastSince Sep 4, 2022 Accepting new patients

Locations

750 S Randall Rd
Algonquin, IL 60102
Phone (847) 458-5341

13460 S Archer Ave
Lemont, IL 60439
Phone (630) 243-6518

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1477273449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021340",
            "telephone_number": "773-600-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7153 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022134",
            "telephone_number": "708-795-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIA",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046011685",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IL",
            "license": "046011685",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.