David A. Maze, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009686 Issued in IL

Practice address

136 N Cass Ave
Westmont, IL 60559-1604

Phone

(630) 969-2807

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Sharon M. Luckhardt Professional name

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern College of Optometry

  • Optometrist
  • Memphis, TN
  • NPI 1851384986
  Medicare reassignment Care Compare group NPD
• The Eye Care Center, LTD.

  • Eyewear Supplier
  • Burbank, IL
  • NPI 1144325358

  Optometrist

  NPD (past)
• Southern College of Optometry

  • Optometrist
  • Memphis, TN
  • NPI 1518309202
  NPD (past)
• State of New York Comptrollers Office

  • Optometrist
  • New York, NY
  • NPI 1407829856
  NPD (past)
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1881796589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591604",
            "telephone_number": "630-969-2807",
            "fax_number": "630-969-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591604",
            "telephone_number": "630-969-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZE",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5984120001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "K NUMBER",
            "identifier": "K16173",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "LUCKHARDT",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Megan Ryan Mateja
• Melvin Mathew
• Katherine Orallo Matias-Riggs, PT
• Andrew Ryan Matthews
• Mark May, D.C.
• Pawel Mazur, MPT
• Julie Marie McDevitt, LCPC
• Roger Scott McDowell, D.C.
• Marin Rose McElroy, PT, DPT
• Kaitlyn McGowan, MOT, OTR/L

• Optometrist in Westmont, IL
• Providers in Westmont, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; 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.

Verify at the official NPI Registry.