Individual provider Active NPI

Peter Jay Epstein, OD.

  • Optometrist
  • Vernon Hills, IL
National Provider Identifier
1730256470
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-006615 Issued in IL
Practice address
335 N Milwaukee Ave
Vernon Hills, IL 60061-1561
Phone
(847) 955-9280
Fax
(847) 955-9282
NPI assigned
Nov 29, 2006
Last updated
Apr 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-006615 IL Primary

Addresses

Primary practice location

335 N Milwaukee Ave
Vernon Hills, IL 60061-1561

Mailing address

5248 RFD
Long Grove, IL 60047-7353
Phone (847) 521-0771

Other identifiers 1

IdentifierTypeStateIssuer
046006615MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-006615ILMDOptometrist

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, 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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1730256470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5248 RFD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600477353",
            "telephone_number": "847-521-0771",
            "fax_number": "847-955-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611561",
            "telephone_number": "847-955-9280",
            "fax_number": "847-955-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "PETER",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "OD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-006615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046006615",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.