Jill Margaret Bert, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.0003048 Issued in CO

Practice address

1931 Sheridan Blvd
Suite S
Edgewater, CO 80214-1316

Phone

(303) 578-8055

NPI assigned

Aug 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Lakefront Eye Care, LLCGroup PAC ID 3072822600, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lakefront Eye Care, LLC

  • Corneal and Contact Management Optometrist
  • Edgewater, CO
  • NPI 1003292954
  Medicare reassignment Care Compare group NPD Authorized official
• Combs Eyecare and Eyewear LTD

  • Eyewear Supplier
  • Western Springs, IL
  • NPI 1013049832
  NPD (past)
• Dr. Thomas S Flach and Associates

  • Family Medicine Physician
  • Western Springs, IL
  • NPI 1659594430
  NPD (past)
• Family Eye Care of Bolingbrook LTD

  • Occupational Vision Optometrist
  • Bolingbrook, IL
  • NPI 1497959795
  NPD (past)
• Robert J S Mack, MD PC

  • Ophthalmology Physician
  • Hoffman Est, IL
  • NPI 1255451563

  Corneal and Contact Management

  NPD (past)
• The Eye Site of Illinois, LLC

  • Optometrist
  • Mount Prospect, IL
  • NPI 1447474879
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1700166121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5773 W 17TH AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802141695",
            "telephone_number": "708-519-0123",
            "fax_number": "303-427-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 SHERIDAN BLVD",
            "address_2": "SUITE S",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141316",
            "telephone_number": "303-578-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERT",
        "first_name": "JILL",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CO",
            "license": "OPT.0003048",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CO",
            "license": "OPT0003048",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CO",
            "license": "OPT.0003048",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CO",
            "license": "OPT.0003048",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CO",
            "license": "OPT.0003048",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CO",
            "license": "OPT.0003048",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63605376",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecilia Anderson
• Jennifer Anderson, P.T.
• Marybeth Aretz, PT
• Alissa Lynae Arteaga
• Sanaz F Ashrafian, RDH
• Jared Boothe
• Natailie Nicole Brennan, M.A. CCC-SLP
• Brothers Redevelopment, Inc
• Bari Candy
• Patrick F Carroll, DMD

• Optometrist in Edgewater, CO
• Providers in Edgewater, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.