Andrea Grider, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011312 Issued in IL

Practice address

9661 W 143Rd St Ste 202
Orland Park, IL 60462-2088

Phone

(708) 361-6141

Fax

(708) 361-5327

NPI assigned

Jun 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: andrea.grider.p1@direct.cec.nextgenshare.com
• Direct secure messaging: drandreagrider@kayeeyecare.direct.eyemdemr.com
• Direct secure messaging: agrider@mep.intellechartdirect.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1861051773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9661 W 143RD ST STE 202",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622088",
            "telephone_number": "708-361-6141",
            "fax_number": "708-361-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9661 W 143RD ST STE 202",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622088",
            "telephone_number": "708-361-6141",
            "fax_number": "708-361-5327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12306 S Harlem Ave",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604632450",
            "country_code": "US",
            "telephone_number": "708-636-5115",
            "fax_number": "708-636-5162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011312",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Greenberg, OTR
• Amy Margaret Greene, LCSW
• Benny Greenspan, DPM
• August Gregory
• Kristen Monica Greiner
• Robert K Griffin, PT
• John Peter Grigus III, D.D.S.
• Nina Gritzalis, PSYD
• Growing Further Coaching PLLC
• Brenda Grzenia

• Optometrist in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.