Individual provider Active NPI

Larissa Nadia Pundy, O.D.

  • Optometrist
  • Arlington Heights, IL
National Provider Identifier
1841311032
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008060 Issued in IL
Practice address
307 N Beverly LN
Arlington Heights, IL 60004-6242
Phone
(847) 590-1097
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-008060 IL Primary

Addresses

Primary practice location

307 N Beverly LN
Arlington Heights, IL 60004-6242

Mailing address

307 N Beverly LN
Arlington Heights, IL 60004-6242
Phone (847) 590-1097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008060ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Diane Lis O.D.S.C. Optometrist Past Accepting new patients

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841311032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N BEVERLY LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600046242",
            "telephone_number": "847-590-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N BEVERLY LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600046242",
            "telephone_number": "847-590-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNDY",
        "first_name": "LARISSA",
        "middle_name": "NADIA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.