Individual provider Active NPI

Oksana Mensheha, M.D.

  • Ophthalmology Physician
  • Libertyville, IL
National Provider Identifier
1679549661
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
36053536 Issued in IL
Practice address
1117 S Milwaukee Ave
Forum Square a-10
Libertyville, IL 60048-3798
Phone
(847) 367-6780
Fax
(847) 367-6861
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 36053536 IL Primary

Addresses

Primary practice location

1117 S Milwaukee Ave
Forum Square a-10
Libertyville, IL 60048-3798

Mailing address

1117 S Milwaukee Ave
Forum Square a-10
Libertyville, IL 60048-3798
Phone (847) 367-6780

Other identifiers 3

IdentifierTypeStateIssuer
0004900798OtherILBLUE CROSS BLUE SHIELD
P00246085OtherILRAILROAD MEDICARE
535994001OtherILDMEPOS SUPPLIER NUMBER

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address omensheha237039@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20050218000067 IL Practitioner - Ophthalmology 9830141589

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Minnesota Medical School, 1967
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1117 S Milwaukee Ave
Forum Square a 10
Libertyville, IL 60048-3798

1117 S Milwaukee Ave Forum Square a
Suite 10
Libertyville, IL 60048-3798

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36053536ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oksana Mensheha, M.D., S.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: omensheha237039@direct.myadvocateaurora.org

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1679549661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "FORUM SQUARE A-10",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-6780",
            "fax_number": "847-367-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "FORUM SQUARE A-10",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-6780",
            "fax_number": "847-367-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSHEHA",
        "first_name": "OKSANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "36053536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0004900798",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00246085",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS SUPPLIER NUMBER",
            "identifier": "535994001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omensheha237039@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1117 S Milwaukee Ave",
            "address_2": "FORUM SQUARE A-10",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483798",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1117 S Milwaukee Ave",
            "address_2": "FORUM SQUARE A-10",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.