Individual provider Active NPI

Rupal Doshi Clair, O.D.

  • Optometrist
  • Gurnee, IL
National Provider Identifier
1811204332
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3199-35 Issued in WI
Practice address
310 S Greenleaf St Ste 209
Gurnee, IL 60031-5708
Phone
(847) 244-1657
Fax
(847) 244-5422
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3199-35 WI Primary

Addresses

Primary practice location

310 S Greenleaf St Ste 209
Gurnee, IL 60031-5708

Mailing address

310 S Greenleaf St Ste 209
Gurnee, IL 60031-5708
Phone (847) 244-1657

Other names 1

  • Rupal Doshi Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rupal.clair.d1.p1@direct.ecclc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20230309001966 WI Practitioner - Optometry 5193198398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emer Eye Care SCGroup PAC ID 0749561801, 3 clinicians

Practice addresses (Care Compare)

6300 76TH St
Suite 100
Kenosha, WI 53142-4018
Phone (262) 654-6005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3199-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emer Eye Care S.C. Optometrist CurrentSince Mar 16, 2023 Accepting new patients

Locations

6300 76th St
#100
Kenosha, WI 53142

Interoperability endpoints

  • Direct secure messaging: rupal.clair.d1.p1@direct.ecclc.nextgenshare.com

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": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1811204332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S GREENLEAF ST STE 209",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315708",
            "telephone_number": "847-244-1657",
            "fax_number": "847-244-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S GREENLEAF ST STE 209",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315708",
            "telephone_number": "847-244-1657",
            "fax_number": "847-244-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAIR",
        "first_name": "RUPAL",
        "middle_name": "DOSHI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3199-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rupal.clair.d1.p1@direct.ecclc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "310 S Greenleaf St Ste 209",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RUPAL",
            "last_name": "DOSHI",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.