KEVIN GOODWIN – Optometrist, NPI 1740697408

KEVIN GOODWIN is a healthcare provider. based in Bolingbrook, Illinois. specializing in OPTOMETRY. They hold a License No. 046010826 (IL). The NPI Number for KEVIN GOODWIN is 1740697408

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN GOODWIN
NPI
1740697408
Phone
(630) 908-0892
Address
653 W BRIARCLIFF RD
Enumeration Date
15 July 2014
Last Update Date
15 July 2014

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
6305841111
Graduation Year
2014 (12 years ago)
PAC ID
5193061836
Group Practice PAC ID
0042289183
Professional Enrollment ID
I20190116003037
Address ID
IL601742203ST1001XSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for KEVIN GOODWIN

  • 653 W BRIARCLIFF RD

    BOLINGBROOK, IL 604402630

    Phone: (630) 908-0892

    Type: Mailing

  • 1050 OGDEN AVE

    MONTGOMERY, IL 605385404

    Phone: (630) 449-1955

    Type: Location

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: 2019-01-16

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
I20190116003037IOptometryILTBD

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
92250Photography of the retina1111$0
View full utilization report →

Insurance plans in this area (ZIP 60440)

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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: 0042289183View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

What is the standard ID for KEVIN GOODWIN in the U.S.?
In the U.S., KEVIN GOODWIN is identified by NPI 1740697408.
Should I treat KEVIN GOODWIN as an active provider?
Patients and plans typically see KEVIN GOODWIN as active in the national extract.
What services align with KEVIN GOODWIN's listing?
KEVIN GOODWIN's public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
Which community is linked to KEVIN GOODWIN?
KEVIN GOODWIN shows a connection to Bolingbrook, Illinois in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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