Aeg Delaware Professional PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AEG DELAWARE PROFESSIONAL PA

Practice address

111 E 4TH St Ste 440
Alton, IL 62002-6206

Phone

(618) 462-9818

NPI assigned

Jul 18, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Allison

Title

Sr. Director RCM/MVC

Phone

(618) 462-9818

Specialties & licenses 1

Addresses

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Aeg Delaware Professional PA

  • Optometrist
  • Alton, IL
  • NPI 1528741543
  NPPES parent name

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roger D. Ammon, O.D.

  • Optometrist
  • Wilmington, DE
  • NPI 1144311010

  DE, Optometrist

  Medicare reassignment Care Compare group NPD
• Anthony P Betts, O.D.

  • Optometrist
  • Wilmington, DE
  • NPI 1720090160

  DE, Optometrist

  Medicare reassignment Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Tax ID family

Aeg Delaware Professional PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Aeg Delaware Professional PA

  • Optometrist
  • Alton, IL
  • NPI 1528741543
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1003596875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG DELAWARE PROFESSIONAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR RCM/MVC",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oluwaseun Regina Adeleke, MD
• Babatunde Adeseye, MD
• Florence Oluwadamilola Adeyemo, MD
• Advanced Wellness Chiropractic and Functional Rehab LLC
• Aeg Connecticut Professional PLLC
• Aeg Delaware Professional PA
• Aeg Kentucky Professional, PLLC
• Aeg Louisiana Professional PC
• Aeg Washington DC Professional PLLC
• Affordable Dentistry Today, PC

• All providers in Alton, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.