Individual provider Active NPI

Sanford Mark Meyers, MD

  • Retina Specialist (Ophthalmology) Physician
  • Des Plaines, IL
National Provider Identifier
1659356186
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
036095435 Issued in IL
Practice address
2454 E Dempster St
400
Des Plaines, IL 60016-5315
Phone
(847) 299-0700
Fax
(847) 390-0616
NPI assigned
Dec 7, 2005
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036095435 IL
Retina Specialist (Ophthalmology) Physician 207WX0107X 036095435 IL Primary

Addresses

Primary practice location

2454 E Dempster St
400
Des Plaines, IL 60016-5315

Mailing address

2454 E Dempster St
400
Des Plaines, IL 60016-5315
Phone (847) 299-0700

Other identifiers 1

IdentifierTypeStateIssuer
036095435MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040717000156 IL Practitioner - Ophthalmology 7810976362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Georgia School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Consultants, LTDGroup PAC ID 4486633922, 11 clinicians

Practice addresses (Care Compare)

2454 E Dempster St
Suite 400
Des Plaines, IL 60016-5320
Phone (847) 299-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036095435ILMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Consultants, LTD CurrentSince Jul 1, 1999 Accepting new patients
Central Eye Care LTD Ophthalmology PastSince Jul 1, 1999 Accepting new patients

Locations

2454 E Dempster St
Ste 400
Des Plaines, IL 60016
Phone (847) 299-0700

755 S Milwaukee Ave
Ste 263
Libertyville, IL 60048
Phone (847) 299-0700

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1659356186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 E DEMPSTER ST",
            "address_2": "400",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165315",
            "telephone_number": "847-299-0700",
            "fax_number": "847-390-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 E DEMPSTER ST",
            "address_2": "400",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165315",
            "telephone_number": "847-299-0700",
            "fax_number": "847-390-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "SANFORD",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036095435",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036095435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095435",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.