Active NPI
Michelle Nicole Manzella, OD
- Optometrist
- Elmhurst, IL
National Provider Identifier
1821613266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011437
- Practice address
- 370 N York St
Elmhurst, IL 60126-2320 - Phone
- (630) 834-6244
- Fax
- (630) 834-2209
- NPI assigned
- Jun 11, 2020
- Last updated
- Nov 20, 2023
- 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 | 046.011437 | IL | Primary |
Addresses
Primary practice location
370 N York St
Elmhurst, IL 60126-2320
Mailing address
370 N York St
Elmhurst, IL 60126-2320
Phone (630) 834-6244
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
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
370 N York St
Elmhurst, IL 60126-2320
Phone (630) 834-6244
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 11 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011437 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark L. Skowron PC | Optometrist | Current | Accepting new patients |
Locations
370 N York St
Elmhurst, IL 60126
Phone (630) 834-6244
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": "1591833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1821613266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 N YORK ST",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601262320",
"telephone_number": "630-834-6244",
"fax_number": "630-834-2209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 N YORK ST",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601262320",
"telephone_number": "630-834-6244",
"fax_number": "630-834-2209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZELLA",
"first_name": "MICHELLE",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-11",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.