Individual provider Active NPI

Lori J. Wassmann, O.D. M.D.

  • Optometrist
  • Bolingbrook, IL
National Provider Identifier
1982706636
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.007567 Issued in IL
Practice address
1243 W Boughton Rd
Bolingbrook, IL 60440-1509
Phone
(630) 679-0900
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.007567 IL Primary

Addresses

Primary practice location

1243 W Boughton Rd
Bolingbrook, IL 60440-1509

Mailing address

1265 Daniel CT
Sycamore, IL 60178-3207
Phone (815) 217-4246

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
I20070720000624 IL Practitioner - Optometry 9335249556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miller Eye Center LTDGroup PAC ID 4880662741, 4 clinicians

Practice addresses (Care Compare)

2995 Eastrock Dr
Rockford, IL 61109-1737
Phone (815) 226-1500

Merit-based Incentive Payment System (MIPS)

Final score
99.5 of 100Reported as group
Quality
95.64
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.007567ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince Dec 1, 2025 Accepting new patients
Miller Eye Center LTD CurrentSince Jul 1, 2023 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Dec 1, 2025 Accepting new patients
Ziva Optical, LTD. Optometrist PastSince Dec 6, 2015 Accepting new patients

Locations

1918 Gateway Center Dr
Belvidere, IL 61008
Phone (815) 547-3456

1550 W Lane Rd
Machesney Park, IL 61115
Phone (815) 668-0533

2995 Eastrock Dr
Rockford, IL 61109
Phone (815) 226-1500

Interoperability endpoints

  • Direct secure messaging: lori.wassmann@uprisedirect.com
  • Direct secure messaging: lwassmann@millereye.intellechartdirect.net

Organizations & group practices 6

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1982706636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 DANIEL CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783207",
            "telephone_number": "815-217-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 W BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401509",
            "telephone_number": "630-679-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSMANN",
        "first_name": "LORI",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "O.D.  M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.007567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.