Individual provider Active NPI

Richard Joseph Nuccio, O.D.

  • Optometrist
  • Bloomingdale, IL
National Provider Identifier
1962526889
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007320 Issued in IL
Practice address
136 W Lake St
Ste 110
Bloomingdale, IL 60108-1020
Phone
(630) 980-9095
Fax
(630) 980-9156
NPI assigned
Mar 17, 2007
Last updated
Feb 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046007320 IL Primary

Addresses

Primary practice location

136 W Lake St
Ste 110
Bloomingdale, IL 60108-1020

Mailing address

136 W Lake St
Ste 110
Bloomingdale, IL 60108-1020
Phone (630) 980-9095

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
I20131021000526 IL Practitioner - Optometry 0446484828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dekalb Optometric Associates, PCGroup PAC ID 7911068598, 4 clinicians

Practice addresses (Care Compare)

121 E Locust St
Dekalb, IL 60115-3207
Phone (815) 756-6388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046007320ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Optometric Associates PC Optometrist CurrentSince Apr 16, 2024 Accepting new patients
Herbert C Becker Jr. MD, SC Past Accepting new patients

Locations

121 E Locust St
DeKalb, IL 60115
Phone (815) 756-6388

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, 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": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1962526889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W LAKE ST",
            "address_2": "STE 110",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081020",
            "telephone_number": "630-980-9095",
            "fax_number": "630-980-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W LAKE ST",
            "address_2": "STE 110",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081020",
            "telephone_number": "630-980-9095",
            "fax_number": "630-980-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCCIO",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.