Individual provider Active NPI

Toshio Nakajima, O.D.

  • Optometrist
  • Elgin, IL
National Provider Identifier
1609924745
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008123 Issued in IL
Practice address
165 S Randall Rd
Elgin, IL 60123
Phone
(847) 888-1555
Fax
(847) 888-2508
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008123 IL
Optometrist 152W00000X 046-008123 IL Primary

Addresses

Primary practice location

165 S Randall Rd
Elgin, IL 60123

Mailing address

165 S Randall Rd
Elgin, IL 60123-5551
Phone (847) 888-1555

Other identifiers 3

IdentifierTypeStateIssuer
410017896OtherILRAILROAD MEDICARE
4515286OtherILBCBS
L08183OtherILPIN

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
I20101015001287 IL Practitioner - Optometry 8729271242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

165 S Randall Rd
Elgin, IL 60123-5551
Phone (847) 888-1555

2100 Troy Rd
Edwardsville, IL 62025-2595
Phone (618) 656-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008123ILMDOptometrist
046008123ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina J. Levi O D P C Optometrist CurrentSince Oct 1, 2021 Accepting new patients
Christina J. Levi O D P C Optometrist Past Accepting new patients
Susan M Penner Optometrist Past Accepting new patients

Locations

134 E Blackhawk Dr
Byron, IL 61010
Phone (815) 234-2020

2100 Troy Rd
Edwardsville, IL 62025
Phone (618) 656-8888

165 S Randall Rd
Elgin, IL 60123
Phone (847) 888-1555

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1609924745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235551",
            "telephone_number": "847-888-1555",
            "fax_number": "847-888-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "847-888-1555",
            "fax_number": "847-888-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAJIMA",
        "first_name": "TOSHIO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008123",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410017896",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4515286",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "L08183",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.