DR. JONATHAN D GOULART (OD) – Optometrist, NPI 1518065176

DR. JONATHAN D GOULART (OD) is a healthcare provider. based in Freeport, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046007745 (IL). The NPI Number for DR. JONATHAN D GOULART (OD) is 1518065176

Main info

Male
42 Years Of Experience
Name
DR. JONATHAN D GOULART (OD)
NPI
1518065176
Phone
(815) 235-6177
Address
1000 KIWANIS DR
Enumeration Date
20 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
8157323121
Graduation Year
1984 (42 years ago)
PAC ID
7618928805
Group Practice PAC ID
7012968209
Professional Enrollment ID
I20050207000298
Address ID
IL610611622OR314XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for DR. JONATHAN D GOULART (OD)

  • 1000, Kiwanis Drive, Freeport, Stephenson County, Illinois, 61032, United States

    FREEPORT, IL 610326921

    Phone: (815) 235-6177

    Fax: (815) 235-6180

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-02-07

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
I20050207000298IOptometryILTBD

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 system3333$0
92004New patient complete exam of visual system1313$0
View full utilization report →

Insurance plans in this area (ZIP 61032)

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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: 7012968209View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
-IL
O P T O M E T R YIL

Reviews

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Frequently asked questions

Is there an official ID for DR. JONATHAN D GOULART (OD) in U.S. healthcare records?
The official identifier for DR. JONATHAN D GOULART (OD) is NPI 1518065176.
Would DR. JONATHAN D GOULART (OD) appear as active to a payer?
You can treat DR. JONATHAN D GOULART (OD) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. JONATHAN D GOULART (OD)?
DR. JONATHAN D GOULART (OD)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. JONATHAN D GOULART (OD) located near Freeport?
DR. JONATHAN D GOULART (OD) currently maps to Freeport, Illinois in this extract.
When was this NPI issued?
Enumeration for DR. JONATHAN D GOULART (OD) is noted as September 20, 2006 where the registry provides it.

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