Jonathan D Goulart, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007745 Issued in IL

Practice address

1000 Kiwanis Dr
Freeport, IL 61032-6921

Phone

(815) 235-6177

Fax

(815) 235-6180

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 1984

Medicare assignment

May accept Medicare assignment

Group practices

Northwest Eyecare PCGroup PAC ID 7012968209, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.74 of 100Reported as group

Quality

73.48

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Eyecare PC

  • Optometrist
  • Freeport, IL
  • NPI 1184800625
  Medicare reassignment Care Compare group NPD
• Rosin Optical Co., Inc

  • Optometrist
  • Berwyn, IL
  • NPI 1235343641
  Medicare reassignment NPD
• Rosin Optical Co. Inc.

  dba Skokie Optical

  • Optometrist
  • Skokie, IL
  • NPI 1750945408
  NPD
• Rosin Optical Co., Inc.

  • Durable Medical Equipment & Medical Supplies
  • Glenview, IL
  • NPI 1881808897

  Optometrist

  NPD
• Jason Lam O.D., M.B.a., Inc.

  dba Eyekonic Family Optometry

  • Optometrist
  • Corona, CA
  • NPI 1598129769
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518065176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 KIWANIS DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326921",
            "telephone_number": "815-235-6177",
            "fax_number": "815-235-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 KIWANIS DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326921",
            "telephone_number": "815-235-6177",
            "fax_number": "815-235-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULART",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007745",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abrar Ghazal, DMD
• Emily Kristine Giglio, M.S., ATC, LAT
• Jeffrey C Gilbert
• Michael Gordon
• Shawn Douglas Gorsline, PT DPT
• Emily Gravenstein
• Brianna Green
• Jennifer Greene
• Madelyn Greenfield, CLS
• Grace Grobe

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.