Individual provider Active NPI

Larry Howard Nierman, O.D.

  • Optometrist
  • Buffalo Grove, IL
National Provider Identifier
1891839114
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0046006885 Issued in IL
Practice address
151 McHenry Rd
Buffalo Grove, IL 60089-1796
Phone
(847) 459-6626
Fax
(847) 459-6696
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0046006885 IL Primary

Addresses

Primary practice location

151 McHenry Rd
Buffalo Grove, IL 60089-1796

Mailing address

151 McHenry Rd
Buffalo Grove, IL 60089-1796
Phone (847) 459-6626

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
I20100205000267 IL Practitioner - Optometry 4880737352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosin Optical Co IncGroup PAC ID 8022921758, 51 clinicians

Practice addresses (Care Compare)

4196 Il Route 83
Long Grove, IL 60047-9563
Phone (847) 955-9999

6233 Cermak Rd
Berwyn, IL 60402-2317
Phone (708) 749-2020

6235 Cermak Rd
Berwyn, IL 60402-2317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0046006885ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nierman Nierman & Nierman Current Accepting new patients
Rosin Optical Co., Inc. CurrentSince Sep 11, 2017 Accepting new patients
Rosin Optical Co., Inc Optometrist Current Accepting new patients

Locations

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

151 McHenry Rd
Buffalo Grove, IL 60089
Phone (312) 337-1126

243 W North Ave
Chicago, IL 60610
Phone (312) 337-1126

Organizations & group practices 3

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1891839114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891796",
            "telephone_number": "847-459-6626",
            "fax_number": "847-459-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891796",
            "telephone_number": "847-459-6626",
            "fax_number": "847-459-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERMAN",
        "first_name": "LARRY",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "0046006885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.