Individual provider Active NPI

Seth Anderson, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1548876220
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011471 Issued in IL
Practice address
5153 S Pulaski Rd Unit B
Chicago, IL 60632-4219
Phone
(773) 284-9844
NPI assigned
Sep 18, 2020
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011471 IL Primary

Addresses

Primary practice location

5153 S Pulaski Rd Unit B
Chicago, IL 60632-4219

Mailing address

5153 S Pulaski Rd Ste B
Chicago, IL 60632-4219
Phone (773) 284-9844

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
I20260330000244 IL Practitioner - Optometry 9133604028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosin Optical Co IncGroup PAC ID 8022921758, 51 clinicians

Practice addresses (Care Compare)

698 Roosevelt Rd
Glen Ellyn, IL 60137-5819
Phone (630) 545-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011471ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pulaski Vision Center LLC Optometrist CurrentSince Sep 20, 2020 Accepting new patients

Locations

5153 S Pulaski Rd
Unit B
Chicago, IL 60632
Phone (773) 284-9844

Organizations & group practices 2

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": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1548876220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5153 S PULASKI RD STE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324219",
            "telephone_number": "773-284-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 S PULASKI RD UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324219",
            "telephone_number": "773-284-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-18",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.