Brian C Sommer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-007309 Issued in IL

Practice address

417 W Jefferson St
Morton, IL 61550-1817

Phone

(309) 263-8611

Fax

(309) 263-8926

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vintage Optical Brian C Sommer OD LTDGroup PAC ID 5597953380, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL HMO C-SNP
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• IL PPO Downstate

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vintage Optical Brian C Sommer OD LTD

  • Optometrist
  • Morton, IL
  • NPI 1073756490
  Medicare reassignment Care Compare group
• Tazewell County Resource Centers Inc

  • Low Vision Rehabilitation Optometrist
  • East Peoria, IL
  • NPI 1265431506
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1003986522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W JEFFERSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501817",
            "telephone_number": "309-263-8611",
            "fax_number": "309-263-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W JEFFERSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501817",
            "telephone_number": "309-263-8611",
            "fax_number": "309-263-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMER",
        "first_name": "BRIAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "410046605",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Smidt
• Peter Smidt, DDS
• Amanda Smith, IBCLC
• Dawn Anne Smith, LCPC
• Janelle Renee Blair Smith, DO
• Deborah Jean Sommer
• Spectrum Health Inc
• Joan Steidinger
• Dana M Stephens, N.P.
• Matthew A Stetter, DO

• Optometrist in Morton, IL
• Providers in Morton, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.

Verify at the official NPI Registry.