Individual provider Active NPI

Soumaiya Masood

  • Optometrist
  • Downers Grove, IL
National Provider Identifier
1497257109
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011166 Issued in IL
Practice address
1402 Butterfield Rd
Downers Grove, IL 60515-1031
Phone
(630) 629-2025
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011166 IL Primary

Addresses

Primary practice location

1402 Butterfield Rd
Downers Grove, IL 60515-1031

Mailing address

1402 Butterfield Rd
Downers Grove, IL 60515-1031

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
I20260602003771 IL Practitioner - Optometry 0749751550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

240 Cimarron Rd E
Lombard, IL 60148-1484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011166ILMDOptometrist

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": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1497257109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 BUTTERFIELD RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BUTTERFIELD RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151031",
            "telephone_number": "630-629-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOOD",
        "first_name": "SOUMAIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.