Individual provider Active NPI

David F. Martin, O.D.

  • Optometrist
  • Aurora, IL
National Provider Identifier
1841204013
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009753 Issued in IL
Practice address
444 N Eola Rd
#105
Aurora, IL 60502-9615
Phone
(630) 862-2020
Fax
(630) 862-2027
NPI assigned
Jul 27, 2006
Last updated
Apr 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009753 IL Primary

Addresses

Primary practice location

444 N Eola Rd
#105
Aurora, IL 60502-9615

Mailing address

444 N Eola Rd
#105
Aurora, IL 60502-9615
Phone (630) 862-2020

Other identifiers 1

IdentifierTypeStateIssuer
046009753OtherILBCBS

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
I20051115000853 IL Practitioner - Optometry 1254350671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Vision Therapy PCGroup PAC ID 2769671718, 2 clinicians

Practice addresses (Care Compare)

452 N Eola Rd
Suite D
Aurora, IL 60502-9110
Phone (630) 862-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009753ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision Therapy PC CurrentSince Oct 2, 2010 Accepting new patients
Eyes of Chicago, LTD Optometrist Past Accepting new patients
Richard F Butz Past Accepting new patients
Oswego Vision, LTD Optometrist PastSince Dec 1, 2005 Accepting new patients

Locations

444 N Eola Rd
Ste 105
Aurora, IL 60502
Phone (630) 862-2020

452 N Eola Rd
Ste D
Aurora, IL 60502
Phone (630) 862-2020

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1841204013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N EOLA RD",
            "address_2": "#105",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029615",
            "telephone_number": "630-862-2020",
            "fax_number": "630-862-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N EOLA RD",
            "address_2": "#105",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029615",
            "telephone_number": "630-862-2020",
            "fax_number": "630-862-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "046009753",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.