Individual provider Active NPI

Michelle K Aung-Kunimura, O.D.

  • Optometrist
  • Aurora, IL
National Provider Identifier
1932238946
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009528 Issued in IL
Practice address
2003 Montgomery Rd
Ste 104
Aurora, IL 60504-9059
Phone
(630) 425-8221
Fax
(630) 425-8222
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 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 046009528 IL Primary

Addresses

Primary practice location

2003 Montgomery Rd
Ste 104
Aurora, IL 60504-9059

Mailing address

2712 High Meadow Rd
Naperville, IL 60564-4375
Phone (331) 684-7026

Other identifiers 1

IdentifierTypeStateIssuer
046009528MedicaidIL

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
I20071026000274 IL Practitioner - Optometry 1153418918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyemax Inc.Group PAC ID 0840528279, 3 clinicians

Practice addresses (Care Compare)

2003 Montgomery Rd
Suite 104
Aurora, IL 60504-9059
Phone (630) 425-8221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
046009528ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyemax Inc. Optometrist CurrentSince May 3, 2011 Accepting new patients
Family Eye Care of Bolingbrook LTD Past Accepting new patients
Visionworks, Inc. Optometrist PastSince Mar 17, 2018 Accepting new patients
Visionworks, Inc Past Accepting new patients

Locations

2003 Montgomery Rd
Ste 104
Aurora, IL 60504
Phone (630) 425-8221

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1932238946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 HIGH MEADOW RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644375",
            "telephone_number": "331-684-7026",
            "fax_number": "630-425-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 MONTGOMERY RD",
            "address_2": "STE 104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605049059",
            "telephone_number": "630-425-8221",
            "fax_number": "630-425-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUNG-KUNIMURA",
        "first_name": "MICHELLE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009528",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.