Individual provider Active NPI

Marija Novakovich, OD

  • Optometrist
  • Westmont, IL
National Provider Identifier
1689394884
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011811 Issued in IL
Practice address
700 E Ogden Ave
Westmont, IL 60559-5569
Phone
(630) 323-7300
NPI assigned
Aug 30, 2022
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 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 046011811 IL Primary

Addresses

Primary practice location

700 E Ogden Ave
Westmont, IL 60559-5569

Mailing address

700 E Ogden Ave
Westmont, IL 60559-5569
Phone (630) 323-7300

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
I20231130001437 IL Practitioner - Optometry 8123404357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarendon Vision Development CenterGroup PAC ID 5799951745, 3 clinicians

Practice addresses (Care Compare)

700 E Ogden Ave
Suite 200
Westmont, IL 60559-1296
Phone (630) 323-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3769TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clarendon Vision Development Center CurrentSince Nov 20, 2023 Accepting new patients
Southern College of Optometry Optometrist PastSince Sep 19, 2022 Accepting new patients

Locations

700 E Ogden Ave
Ste 200
Westmont, IL 60559
Phone (630) 323-7300

760 Pasquinelli Dr
Ste 300
Westmont, IL 60559
Phone (630) 323-7300

Interoperability endpoints

  • Direct secure messaging: mnovakovich25319@direct.midwestern.edu

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1689394884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595569",
            "telephone_number": "630-323-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595569",
            "telephone_number": "630-323-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAKOVICH",
        "first_name": "MARIJA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.