Central Illinois Vision Center is a medicare enrolled "Ophthalmology" provider in Decatur, Illinois. Their current practice location is
2442 N Route 121, Decatur, Illinois. You can reach out to their office (for appointments etc.) via phone at
(217) 233-3101.
Central Illinois Vision Center is licensed to practice in Illinois (license number 036069820) and it also participates in the medicare program. Central Illinois Vision Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1093854820.
Healthcare Provider's Profile
| Full Name | Central Illinois Vision Center |
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| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 2442 N Route 121, Decatur, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1093854820
- Provider Enumeration Date: 02/06/2007
- Last Update Date: 04/24/2008
Medicare PECOS Information:
- PECOS PAC ID: 5496780736
- Enrollment ID: O20051005000658
Medical Identifiers
Medical identifiers for Central Illinois Vision Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093854820 | NPI | - | NPPES |
| 036069820 | Medicaid | IL | |
| 180033361 | Other | IL | RAILROAD MEDICARE |
| 05822331 | Other | IL | BLUE CROSS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 046009767 (Illinois) | Secondary |
| 152WC0802X | Optometrist - Corneal And Contact Management | 036069820 (Illinois) | Secondary |
| 207W00000X | Ophthalmology | 036069820 (Illinois) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 036069820 (Illinois) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Central Illinois Vision Center acts as a billing entity for following providers:
| Provider Name | Nathan A Crouch |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1750386215
PECOS PAC ID: 9931176799
Enrollment ID: I20040913000543 |
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| Provider Name | Marcus S Deranian |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1952367351
PECOS PAC ID: 4587699830
Enrollment ID: I20080125000472 |
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| Provider Name | Dennis Rabe |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1710980560
PECOS PAC ID: 7113032889
Enrollment ID: I20110223000593 |
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| Provider Name | Maxx M Craggs |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1942680228
PECOS PAC ID: 3577874353
Enrollment ID: I20150619001489 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Central Illinois Vision Center is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Central Illinois Vision Center
2442 N Route 121,
Decatur, IL 62526-9461
Ph: (217) 233-3101 | Central Illinois Vision Center
2442 N Route 121,
Decatur, IL 62526-9461
Ph: (217) 233-3101 |
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