Active NPI
Samantha F Madro, OD
- Optometrist
- Park Ridge, IL
National Provider Identifier
1790393841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011443
- Practice address
- 140 N Northwest Hwy
Park Ridge, IL 60068-3342 - Phone
- (847) 292-1805
- NPI assigned
- Jul 15, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.011443 | IL | Primary |
Addresses
Primary practice location
140 N Northwest Hwy
Park Ridge, IL 60068-3342
Mailing address
1513 Illinois St
Schaumburg, IL 60193-4670
Phone (630) 512-1987
Other practice location 1
7345 Lake St
River Forest, IL 60305-2206
Phone (708) 771-0769
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1513 Illinois St
Schaumburg, IL 60193-4670
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011443 | IL | MD | Optometrist |
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": "1594771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1790393841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 ILLINOIS ST",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601934670",
"telephone_number": "630-512-1987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 N NORTHWEST HWY",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600683342",
"telephone_number": "847-292-1805"
}
],
"practiceLocations": [
{
"address_1": "7345 Lake St",
"address_purpose": "LOCATION",
"city": "River Forest",
"state": "IL",
"postal_code": "603052206",
"country_code": "US",
"telephone_number": "708-771-0769",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MADRO",
"first_name": "SAMANTHA",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-15",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.