Individual provider Active NPI

Vandana Patel, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1912159591
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010198 Issued in IL
Practice address
1926 W Irving Park Rd
Chicago, IL 60613-2408
Phone
(773) 525-0952
Fax
(773) 525-0966
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010198 IL Primary
Optometrist 152W00000X 2760 CT

Addresses

Primary practice location

1926 W Irving Park Rd
Chicago, IL 60613-2408

Mailing address

1926 W Irving Park Rd
Chicago, IL 60613-2408
Phone (773) 525-0952

Other identifiers 1

IdentifierTypeStateIssuer
1600854OtherILBCBS OF IL

Other names 1

  • Dr. Vandana Gandhi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191023000347 GA Practitioner - Optometry 6305980962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2760CTMDMarriage & Family Therapist
046010198ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle B Edwards OD PC Optometrist CurrentSince Aug 15, 2019 Accepting new patients
Fenner Plastic Surgery, LTD. Past Accepting new patients
Wyse Eyecare SC PastSince Sep 1, 2010 Accepting new patients

Locations

7824 Hickory Flat Hwy
Ste 100
Woodstock, GA 30188
Phone (404) 375-5637

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1912159591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132408",
            "telephone_number": "773-525-0952",
            "fax_number": "773-525-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132408",
            "telephone_number": "773-525-0952",
            "fax_number": "773-525-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VANDANA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010198",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "1600854",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANDANA",
            "last_name": "GANDHI",
            "prefix": "DR.",
            "credential": "O.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.