DR. FORUM PURNENDU DAVE (O.D.) – Optometrist, NPI 1043695901

DR. FORUM PURNENDU DAVE (O.D.) is a healthcare provider. based in Des plaines, Illinois. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 046.010886 (IL). The NPI Number for DR. FORUM PURNENDU DAVE (O.D.) is 1043695901

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. FORUM PURNENDU DAVE (O.D.)
NPI
1043695901
Phone
(847) 294-6722
Address
1070 E OAKTON ST
Enumeration Date
21 July 2015
Last Update Date
8 November 2016

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
8472946722
Graduation Year
2015 (11 years ago)
PAC ID
1355638818
Group Practice PAC ID
4880752278
Professional Enrollment ID
I20160927001307
Address ID
IL600182033DE1070XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for DR. FORUM PURNENDU DAVE (O.D.)

  • 1070 E OAKTON ST

    DES PLAINES, IL 600182033

    Phone: (847) 294-6722

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $103.

Total Amount is formed as General ($103) + Research ($0) + Ownership ($0) = $103.

Last reported payment date: 2024-02-28 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($103).

Total Amount

$103

General + Research + Ownership

Payments

1

Total payment records

General Amount

$103

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-28

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-09-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160927001307IOptometryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system3737$0
92004New patient complete exam of visual system1212$0
View full utilization report →

Insurance plans in this area (ZIP 60018)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880752278View full group profile
NameSpecialtyState
O P T O M E T R YIL

Reviews

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Frequently asked questions

How do payers reference DR. FORUM PURNENDU DAVE (O.D.)?
For DR. FORUM PURNENDU DAVE (O.D.), use NPI 1043695901 as the unique 10-digit identifier.
Is DR. FORUM PURNENDU DAVE (O.D.) shown as active in public data?
Registry records indicate DR. FORUM PURNENDU DAVE (O.D.) maintains an active NPI.
What expertise is attributed to DR. FORUM PURNENDU DAVE (O.D.)?
DR. FORUM PURNENDU DAVE (O.D.)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Where in Illinois is DR. FORUM PURNENDU DAVE (O.D.) registered?
Use Des Plaines, Illinois as the headline location for DR. FORUM PURNENDU DAVE (O.D.) here.
When was this NPI issued?
Enumeration for DR. FORUM PURNENDU DAVE (O.D.) is noted as July 21, 2015 where the registry provides it.

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