Individual provider Active NPI

Shivani Kamlesh Patel

  • Optometrist
  • Naperville, IL
National Provider Identifier
1780319145
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011700 Issued in IL
Practice address
1000 E Ogden Ave
Naperville, IL 60563-8616
Phone
(630) 355-9080
Fax
(630) 355-9179
NPI assigned
Jul 20, 2022
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL
Optometrist 152W00000X 046011700 IL Primary

Addresses

Primary practice location

1000 E Ogden Ave
Naperville, IL 60563-8616

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20221129000116 IL Practitioner - Optometry 4981072725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 E Ogden Ave
Naperville, IL 60563-8616
Phone (630) 355-9080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Oct 10, 2022 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Oct 10, 2022 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Past Accepting new patients

Locations

310 S Weber Rd
Bolingbrook, IL 60490
Phone (630) 771-0600

2842 N Sheridan Rd
Chicago, IL 60657
Phone (773) 525-8700

3627 N Western Ave
Chicago, IL 60618
Phone (773) 525-2022

5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020

1114 W Devon Ave
Elk Grove Village, IL 60007
Phone (847) 895-7222

138 N York St
Elmhurst, IL 60126
Phone (630) 279-2020

104 S Washington St
Hinsdale, IL 60521
Phone (630) 323-1100

1000 E Ogden Ave
Naperville, IL 60563
Phone (630) 355-9010

2555 W 75th St
Ste 119
Naperville, IL 60540
Phone (630) 225-7020

122 N Oak Park Ave
Oak Park, IL 60301
Phone (708) 524-2020

55 E Main St
Roselle, IL 60172
Phone (630) 529-0993

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1780319145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E OGDEN AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638616",
            "telephone_number": "630-355-9080",
            "fax_number": "630-355-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVANI",
        "middle_name": "KAMLESH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.