Individual provider Active NPI

Carrie Sypherd, O.D.

  • Optometrist
  • Crystal Lake, IL
National Provider Identifier
1992756290
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009482 Issued in IL
Practice address
820 E Terra Cotta Ave
Suite 256
Crystal Lake, IL 60014-3649
Phone
(815) 455-2800
Fax
(815) 455-2801
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 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 046009482 IL Primary

Addresses

Primary practice location

820 E Terra Cotta Ave
Suite 256
Crystal Lake, IL 60014-3649

Mailing address

820 E Terra Cotta Ave
Suite 256
Crystal Lake, IL 60014-3649
Phone (815) 455-2800

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
I20050705000301 IL Practitioner - Optometry 8426093816 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois Medical College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bartlett Vision Center PCGroup PAC ID 2365461332, 2 clinicians

Practice addresses (Care Compare)

26 W171 Roosevelt Rd
Wheaton, IL 60187-6002
Phone (630) 909-8000

810 W Bartlett Rd
Bartlett, IL 60103-4402
Phone (630) 837-9500

820 E Terra Cotta Ave
Suite 256
Crystal Lake, IL 60014-3655
Phone (815) 455-2800

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009482ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Vision, LTD. CurrentSince Dec 27, 2009 Accepting new patients
Sypherd Optical Inc. CurrentSince Jul 15, 2009 Accepting new patients
Bartlett Vision Center PC Optometrist CurrentSince Apr 20, 2008 Accepting new patients
Jass Eyecare P.C. Optometrist PastSince Jan 12, 2020 Accepting new patients

Locations

810 W Bartlett Rd
Bartlett, IL 60103
Phone (630) 837-9500

820 E Terra Cotta Ave
Ste 256
Crystal Lake, IL 60014
Phone (815) 455-2800

820 E Terra Cotta Ave
Crystal Lake, IL 60014
Phone (815) 444-1330

26W171 Roosevelt Rd
Wheaton, IL 60187
Phone (630) 462-4000

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1992756290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE",
            "address_2": "SUITE 256",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143649",
            "telephone_number": "815-455-2800",
            "fax_number": "815-455-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE",
            "address_2": "SUITE 256",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143649",
            "telephone_number": "815-455-2800",
            "fax_number": "815-455-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYPHERD",
        "first_name": "CARRIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.