Shaun T Ittiara, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

036.127360 Issued in IL

Practice address

2600 S Michigan Ave Ste 212
Chicago, IL 60616-2859

Phone

(312) 567-2795

Fax

(800) 707-4890

NPI assigned

Jul 30, 2007

Last updated

Jul 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

Wayne State University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cook CountyGroup PAC ID 2860398088, 770 clinicians

Retinal Vitreal Consultants LTDGroup PAC ID 4385721588, 3 clinicians

The University of Chicago Medical CenterGroup PAC ID 7618880766, 907 clinicians

University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IAJCBD
• Direct secure messaging: shaun.ittiara.iei@direct.ico.nextgenshare.com
• Direct secure messaging: sittiaramd38869@uchospital.direct-ci.com

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.

• Retinal Vitreal Consultants LTD

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1164569380
  Medicare reassignment Care Compare group NPD Authorized official
• Cook County

  dba John H. Stroger, Jr. Hospital of Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment Care Compare group NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment Care Compare group NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment Care Compare group NPD
• Helix Eye Care PC

  • Ophthalmology Physician
  • Schererville, IN
  • NPI 1477947034
  Medicare reassignment NPD
• Cook County

  dba Cook County Health & Hospitals System Physician Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  dba Bronzeville Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD
• Acculab Medical Testing Inc

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1699222000
  NPD (past)
• Retina Associates LTD

  • Ophthalmology Physician
  • Elmhurst, IL
  • NPI 1629067673
  NPD (past)

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

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1992995542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166516",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606166516",
            "telephone_number": "312-567-2795",
            "fax_number": "800-707-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S MICHIGAN AVE STE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162859",
            "telephone_number": "312-567-2795",
            "fax_number": "800-707-4890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4429 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532625",
            "country_code": "US",
            "telephone_number": "708-442-2665",
            "fax_number": "708-422-2997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3241 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606164201",
            "country_code": "US",
            "telephone_number": "312-949-7221",
            "fax_number": "312-949-7667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5758 S. Maryland Ave",
            "address_2": "DCAM Eye Center",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60637",
            "country_code": "US",
            "telephone_number": "773-702-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITTIARA",
        "first_name": "SHAUN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036127360",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036.127360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaun.ittiara@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": []
}

• Lawrence H. Iteld, MD
• Sina Ith, PHARMD
• Marya Itkina, LMT
• Gail S Itokazu, PHARMD
• Regina Itteera, PHARM.D.
• Colleen McKenna Ittner, AU.D.
• Erica A Ittner, OD
• Jessica Ittner, FNP-BC
• Maider Ituarte
• Itunu LLC

• Retina Specialist (Ophthalmology) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Retina Specialist (Ophthalmology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.