Individual provider Active NPI

Alexandria E Scatchell, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1992848071
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.9919 Issued in IL
Practice address
4151 W Peterson Ave
Chicago, IL 60646-6002
Phone
(773) 685-5606
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.9919 IL Primary

Addresses

Primary practice location

4151 W Peterson Ave
Chicago, IL 60646-6002

Mailing address

6307 N Minnehaha Ave
Chicago, IL 60646-4120
Phone (773) 458-3230

Other identifiers 1

IdentifierTypeStateIssuer
046.9919MedicaidIL

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
I20120822000399 IL Practitioner - Optometry 2769639038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.9919ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare Alexis E Scatchell OD CurrentSince Jan 5, 2023 Accepting new patients
Family Eyecare Alexis E Scatchell OD Optometrist CurrentSince Jan 8, 2023 Accepting new patients

Locations

4151 W Peterson Ave
Chicago, IL 60646
Phone (773) 685-5606

5316 N Milwaukee Ave
#2C
Chicago, IL 60630
Phone (708) 831-4564

5355 W Devon Ave
Chicago, IL 60646
Phone (773) 930-4035

Organizations & group practices 2

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1992848071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6307 N MINNEHAHA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464120",
            "telephone_number": "773-458-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466002",
            "telephone_number": "773-685-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCATCHELL",
        "first_name": "ALEXANDRIA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.9919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046.9919",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.