Individual provider Active NPI

Bradford Newton, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1518155241
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.007441 Issued in IL
Practice address
3948 W 26TH St
Ste 102
Chicago, IL 60623-3740
Phone
(773) 542-2020
Fax
(773) 542-7050
NPI assigned
Oct 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.007441 IL Primary

Addresses

Primary practice location

3948 W 26TH St
Ste 102
Chicago, IL 60623-3740

Mailing address

11103 West Ave
Ste. 6
San Antonio, TX 78213-1370
Phone (210) 524-6663

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
I20080121000008 IL Practitioner - Optometry 1153402862 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.007441ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Eye Center Optometrist PastSince Jul 24, 2022 Accepting new patients
Visionworks, Inc Past Accepting new patients
Visionworks, Inc Past Accepting new patients
Visionworks, Inc. Optometrist PastSince Mar 17, 2018 Accepting new patients

Organizations & group practices 4

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": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1518155241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "STE. 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6663",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 W 26TH ST",
            "address_2": "STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233740",
            "telephone_number": "773-542-2020",
            "fax_number": "773-542-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "BRADFORD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.007441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.