DR. CRAIG H GERSTEIN M.D.
NPI 1083712681
Ophthalmology in Chicago, IL

Q: What is Craig Gerstein's NPI number?

The NPI number for Craig Gerstein is 1083712681. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Q: What is Craig Gerstein's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Craig Gerstein was last updated on December 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 20, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

3042 W PETERSON AVE, CHICAGO, IL 60659(773) 973-3223(773) 973-1119 Get Directions Write a Review

NPPES record last updated: December 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Craig H Gerstein M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CRAIG H GERSTEIN M.D. (NPI 1083712681) is an individual ophthalmology provider in Chicago, Illinois, licensed in Illinois (036-104297) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Advocate Illinois Masonic Medical Center, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1083712681

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. CRAIG H GERSTEINCredential: M.D.

Location Address3042 W PETERSON AVEChicago, IL 60659-3729

Mailing Address3042 W Peterson AveChicago, IL 60659-3729 · (773) 973-3223 · Fax (773) 973-1119

Phone(773) 973-3223

Fax(773) 973-1119

Sole ProprietorYes

Medical School CMSOtherGraduated 1997

Enumeration DateSeptember 20, 2006

Last NPPES UpdateDecember 28, 2021

NPPES CertifiedDecember 28, 2021

✔ NPI 1083712681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in IL · 036-104297

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

3042 W PETERSON AVE, Chicago, IL 60659

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Other Identifiers 3

Medicaid036104297-1IL

Other180042637IL · Railroad Medicare Number

Other1627829IL · Bcbs Provider Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Craig H Gerstein M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779470992

PECOS Enrollment IDI20041008000249

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

1,270 services1,031 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

422 services250 patients

Extended exam of the back part of the eye with optic nerve drawing 92202

This procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.

222 services156 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

188 services188 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

178 services118 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

176 services168 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

115 services113 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

115 services100 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

106 services66 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

71 services71 patients

Administration and interpretation of patient-focused health risk assessment 96160

This procedure involves a detailed evaluation of your health to identify potential risks. It includes analyzing your medical history, lifestyle habits, and family health history. The results are interpreted to provide a personalized plan to improve your health and prevent future issues.

68 services61 patients

Insertion of drug delivery implant into tear duct of eye 68841

This procedure involves placing a small implant into your tear duct. The implant slowly releases medication to your eye, helping manage conditions like dry eyes or glaucoma. It's a simple, quick procedure typically performed under local anesthesia.

55 services34 patients

Complex removal of cataract with insertion of prosthetic lens 66982

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

53 services36 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

48 services42 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

42 services40 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

21 services21 patients

Exam to measure eye deviation and range of motion 92060

This is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.

20 services19 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Illinois Masonic Medical Center

Acute Care Hospitals · Chicago, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140182

Location836 West Wellington AvenueChicago, IL 60657 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60659 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

100

Improvement Activities

Cost

95.54

Reported Quality Measures

Cataract Surgery: Difference Between Planned and Final Refraction

99%186 patients4/55-star benchmark: 100%

Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

98%142 patients4/55-star benchmark: 100%

Diabetes: Eye Exam

100%816 patients5/55-star benchmark: 100%

Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

100%90 patients5/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

100%5,670 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

100%2,229 patients5/55-star benchmark: 100%

Glaucoma Intraocular Pressure Reduction

93%375 patients

Overuse of Imaging for the Evaluation of Primary Headache

Lower rates are better for this measure.

0%34 patients

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care

100%229 patients

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 2,307 patients

Patients totalRate: 0% · 2,307 patients

0%2,307 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020

Other-Vision, Hearing, and Speech Services · category OC000N

2 suppliers34 claims34 services$58.38 avg. paid by Medicare

Sphere, single vision, plano to plus or minus 4.00, per lens V2100

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier12 claims24 services$37.77 avg. paid by Medicare

Sphere, bifocal, plano to plus or minus 4.00d, per lens V2200

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier18 claims35 services$42.57 avg. paid by Medicare

U-v lens, per lens V2755

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier35 claims70 services$13.89 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GERSTEIN EYE INSTITUTE

Ophthalmology

3042 W PETERSON AVE
CHICAGO, IL 60659

Cook County (773) 973-3223

DR. MELVYN A GERSTEIN M.D.

Ophthalmology

3042 W PETERSON AVE
CHICAGO, IL 60659

Cook County (773) 973-3223

GERSTEIN IOR LLC

Clinic/Center (Ambulatory Surgical)

3042 W PETERSON AVE
CHICAGO, IL 60659

Cook County (773) 973-3223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Craig Gerstein's NPI number?

The NPI number for Craig Gerstein is 1083712681. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Craig Gerstein located?

Craig Gerstein practices at 3042 W Peterson Ave, Chicago, IL 60659. The listed phone number is (773) 973-3223.

What is Craig Gerstein's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Craig Gerstein enrolled in Medicare?

Yes. Craig Gerstein is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Craig Gerstein accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Craig Gerstein as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Craig Gerstein affiliated with any hospitals?

According to CMS data, Craig Gerstein is affiliated with Advocate Illinois Masonic Medical Center.

When was this NPI record last updated?

The NPPES record for Craig Gerstein was last updated on December 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.