Active NPI
Jason Richard Diehl, O.D.
- Optometrist
- Columbia, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-009550
- Practice address
- 1025 Columbia Ctr
Columbia, IL 62236-2546 - Phone
- (618) 281-8611
- Fax
- (618) 281-3927
- NPI assigned
- Mar 18, 2006
- Last updated
- Oct 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046-009550 | IL | Primary |
Addresses
Primary practice location
1025 Columbia Ctr
Columbia, IL 62236-2546
Mailing address
40 E North St
Eureka, MO 63025-1205
Phone (636) 200-4393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1025 Columbia Ctr
Columbia, IL 62236-2546
Phone (618) 281-8611
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-009550 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarkson Optometry Illinois, P.C. | Optometrist | Current | Accepting new patients |
| Clarkson Optometry Illinois, P.C. | Optometrist | Current | Accepting new patients |
| Nu-Crown, LLC | Optometrist | Past | Accepting new patients |
Locations
1025 Columbia Centre
Columbia, IL 62236
Phone (618) 281-8611
6663 Edwardsville Crossing Dr
#B
Edwardsville, IL 62025
Phone (618) 659-2320
3405 Nameoki Rd
Ste A
Granite City, IL 62040
Phone (618) 219-8909
3248 Green Mount Crossing Dr
Shiloh, IL 62269
Phone (618) 622-9225
204 Bradford Ln
Waterloo, IL 62298
Phone (618) 939-6163
15933 Clayton Rd
Ste 201
Ballwin, MO 63011
Networks
- IL PPO Downstate
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- IL HMO C-SNP
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
Interoperability endpoints
- jasondiehl@direct.eyecare-partners.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1003875147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 E NORTH ST",
"city": "EUREKA",
"state": "MO",
"postal_code": "630251205",
"telephone_number": "636-200-4393",
"fax_number": "636-938-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 COLUMBIA CTR",
"city": "COLUMBIA",
"state": "IL",
"postal_code": "622362546",
"telephone_number": "618-281-8611",
"fax_number": "618-281-3927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEHL",
"first_name": "JASON",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-18",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-009550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, IL
- Carrie A Daigle, MD
- Laurie Dauphin, RPH
- Deaconess Illinois Clinic, Inc (Deaconess IL Clinic Eleven S)
- Jason R Delaney, PT
- Kevin P Devine, DMD
- Heidi Donald, LCSW
- Deanna Rae Douglass, PHARMD
- Renee Elizabeth Doyle, D.M.D
- Ear, Nose & Throat Institute of Southern Illinois LTD.
- Early Wonders Pediatrics, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.