Individual provider Active NPI

Maryjo McCartan, OD

  • Optometrist
  • Orland Park, IL
National Provider Identifier
1619214301
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008779 Issued in IL
Practice address
24 Orland Square Dr
Orland Park, IL 60462-3207
Phone
(708) 403-3555
Fax
(708) 403-6602
NPI assigned
Jan 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008779 IL Primary

Addresses

Primary practice location

24 Orland Square Dr
Orland Park, IL 60462-3207

Mailing address

2600 N Southport Ave
#209
Chicago, IL 60614-1134
Phone (773) 590-4740

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
I20130724000472 IL Practitioner - Optometry 5395986996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gervais - Floyd LTDGroup PAC ID 7911147814, 3 clinicians

Practice addresses (Care Compare)

24 Orland Square Dr
Orland Park, IL 60462-3207
Phone (708) 403-3555

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046008779ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gervais-Floyd, LTD Optometrist CurrentSince Apr 29, 2013 Accepting new patients

Locations

24 Orland Square Dr
Orland Park, IL 60462
Phone (708) 403-3555

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": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1619214301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N SOUTHPORT AVE",
            "address_2": "#209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141134",
            "telephone_number": "773-590-4740",
            "fax_number": "708-403-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ORLAND SQUARE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623207",
            "telephone_number": "708-403-3555",
            "fax_number": "708-403-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTAN",
        "first_name": "MARYJO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.