Individual provider Active NPI

Sarah Jean Reitz, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1912349770
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.010702 Issued in IL
Practice address
3500 W Peterson Ave Ste 401
Chicago, IL 60659-3307
Phone
(773) 588-3090
Fax
(773) 588-3210
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.010702 IL Primary

Addresses

Primary practice location

3500 W Peterson Ave Ste 401
Chicago, IL 60659-3307

Mailing address

808 N Route 59
Aurora, IL 60504-4912
Phone (630) 585-0516

Other practice location 1

808 N Route 59
Aurora, IL 60504-4912
Phone (630) 585-0516

Other identifiers 1

IdentifierTypeStateIssuer
046010702MedicaidIL

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
I20150626000381 IL Practitioner - Optometry 3375854763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.24 of 100Reported as group
Quality
74.48
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.010702ILMDOptometrist

Organizations & group practices 1

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1912349770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N ROUTE 59",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044912",
            "telephone_number": "630-585-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 W PETERSON AVE STE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593307",
            "telephone_number": "773-588-3090",
            "fax_number": "773-588-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 N Route 59",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605044912",
            "country_code": "US",
            "telephone_number": "630-585-0516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REITZ",
        "first_name": "SARAH",
        "middle_name": "JEAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010702",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.