NPIMap

Individual provider Active NPI

Nathaniel M Erdman, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1982860557
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010139 Issued in IL
Practice address
4053 N Sheridan Rd
Unit 5
Chicago, IL 60613-2086
Phone
(314) 369-2219
NPI assigned
Aug 4, 2008
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010139 IL Primary

Addresses

Primary practice location

4053 N Sheridan Rd
Unit 5
Chicago, IL 60613-2086

Mailing address

4053 N Sheridan Rd
Unit 5
Chicago, IL 60613-2086
Phone (314) 369-2219

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nerdman@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000775 IL Practitioner - Optometry 6204999311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010139ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County CurrentSince Apr 19, 2016 Accepting new patients
Cook County CurrentSince Apr 19, 2016 Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

1900 W Polk St
Ste 1231
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Interoperability endpoints

  • Direct secure messaging: nerdman@direct.ccprovider.org

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1982860557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4053 N SHERIDAN RD",
            "address_2": "UNIT 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132086",
            "telephone_number": "314-369-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 N SHERIDAN RD",
            "address_2": "UNIT 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132086",
            "telephone_number": "314-369-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMAN",
        "first_name": "NATHANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nerdman@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.