Individual provider Active NPI

Snehali A Upadhyay, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1861620833
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010217 Issued in IL
Practice address
3241 S Michigan Ave
Chicago, IL 60616-3878
Phone
(312) 225-6200
Fax
(312) 949-7660
NPI assigned
Jun 29, 2009
Last updated
Jul 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010217 IL Primary

Addresses

Primary practice location

3241 S Michigan Ave
Chicago, IL 60616-3878

Mailing address

3241 S Michigan Ave
Chicago, IL 60616-3878
Phone (312) 225-6200

Other identifiers 1

IdentifierTypeStateIssuer
046010217MedicaidIL

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
I20090714000298 IL Practitioner - Optometry 4486706942 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Eyecare of Hanover Park CorpGroup PAC ID 9537526173, 2 clinicians

Practice addresses (Care Compare)

113 E Schaumburg Rd
Schaumburg, IL 60194-3518
Phone (630) 635-2612

1156 E Lake St
Hanover Park, IL 60133-5421
Phone (630) 855-5542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010217ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois College of Optometry Optometrist CurrentSince Jul 1, 2009 Accepting new patients
Advanced Eyecare of Hanover Park, Corp. Optometrist CurrentSince Apr 15, 2023 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

1156 E Lake St
Hanover Park, IL 60133
Phone (630) 855-5542

1156 E Lake St
Unit B6
Hanover Park, IL 60133

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1861620833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163878",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163878",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPADHYAY",
        "first_name": "SNEHALI",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010217",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.