Individual provider Active NPI

Ameera Sulakhe, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1619330263
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011259 Issued in IL
Practice address
5315 W Devon Ave
Chicago, IL 60646-4102
Phone
(773) 775-6555
Fax
(773) 775-3350
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33358 CA
Optometrist 152W00000X 046.011259 IL Primary

Addresses

Primary practice location

5315 W Devon Ave
Chicago, IL 60646-4102

Mailing address

9241 Menard Ave
Morton Grove, IL 60053-1563
Phone (909) 964-3661

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
I20200716001902 IL Practitioner - Optometry 6002105913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5315 W Devon Ave
Edgebrook Vision Center
Chicago, IL 60646-4107
Phone (773) 775-6555

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33358CAMDProsthodontist
046.011259ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ameera Sulakhe, O.D. Inc. Optometrist CurrentSince Jun 18, 2020 Accepting new patients
Kamran Hussain Incorporated Optometrist PastSince May 1, 2020 Accepting new patients
Edgebrook Vision Center LLC PastSince Jun 18, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ameera.sulakhe@uprisedirect.com

Organizations & group practices 3

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1619330263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 MENARD AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600531563",
            "telephone_number": "909-964-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464102",
            "telephone_number": "773-775-6555",
            "fax_number": "773-775-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAKHE",
        "first_name": "AMEERA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33358",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.