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DR. GUILLERMO GAMBOA O.D.
NPI 1982897005
Optometrist in Chicago, IL

Active since August 22, 2007PECOS EnrolledAccepts Medicare Assignment
87.49/100
CMS Quality Rating
10434 S KEDZIE AVE, CHICAGO, IL 60655(773) 445-2700(773) 445-2325 Get Directions Write a Review

NPPES record last updated: August 22, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Guillermo Gamboa O.d. NPPES

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

DR. GUILLERMO GAMBOA O.D. (NPI 1982897005) is an individual optometrist in Chicago, Illinois and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2003).

NPPES Registry Identity

NPI1982897005
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. GUILLERMO GAMBOACredential: O.D.
Location Address10434 S KEDZIE AVEChicago, IL 60655-2018
Mailing Address10434 S Kedzie AveChicago, IL 60655-2018 · (773) 445-2700 · Fax (773) 445-2325
Phone(773) 445-2700
Fax(773) 445-2325
Sole ProprietorYes
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2003
Enumeration DateAugust 22, 2007
✔ NPI 1982897005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Also ListedOptometrist · Sports VisionTaxonomy 152WS0006X
Also ListedOptometrist · Vision TherapyTaxonomy 152WV0400X
10434 S KEDZIE AVE, Chicago, IL 60655
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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. Guillermo Gamboa O.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 ID446412639
PECOS Enrollment IDI20120504000307
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 5

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.
220 services218 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
130 services127 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
35 services33 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
32 services32 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
19 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60655 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.

87.49/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality92.74
Improvement Activities40
Cost68

Other Providers at the Same Location NPPES 2

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

BUSH FAMILY EYE CARE, LLC
Optometrist
10434 S KEDZIE AVE
CHICAGO, IL 60655
Cook County (773) 445-2700
ELIZABETH JANE BUSH O.D.
Optometrist
10434 S KEDZIE AVE
CHICAGO, IL 60655
Cook County (773) 445-2700

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 Guillermo Gamboa's NPI number?

The NPI number for Guillermo Gamboa is 1982897005. It was assigned to this individual provider in the NPPES registry on August 22, 2007.

Where is Guillermo Gamboa located?

Guillermo Gamboa practices at 10434 S Kedzie Ave, Chicago, IL 60655. The listed phone number is (773) 445-2700.

What is Guillermo Gamboa's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Guillermo Gamboa enrolled in Medicare?

Yes. Guillermo Gamboa 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 Guillermo Gamboa accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Guillermo Gamboa 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.

When was this NPI record last updated?

The NPPES record for Guillermo Gamboa was last updated on August 22, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.