Individual provider Active NPI

Mark Allen Nekola, MD

  • Ophthalmology Physician
  • Swansea, IL
National Provider Identifier
1073509766
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036092365 Issued in IL
Practice address
3990 N Illinois St
Swansea, IL 62226-1919
Phone
(618) 277-1130
Fax
(618) 277-4917
NPI assigned
Sep 27, 2005
Last updated
Sep 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036092365 IL Primary

Addresses

Primary practice location

3990 N Illinois St
Swansea, IL 62226-1919

Mailing address

4900 W Main St
Belleville, IL 62226-4725
Phone (618) 235-2400

Other identifiers 3

IdentifierTypeStateIssuer
08215191OtherILBCBS
18007717OtherRR MEDICARE
036092365MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101005000570 IL Practitioner - Ophthalmology 7719031806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Saint Louis University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JFJ Eyecare LTDGroup PAC ID 8224009865, 13 clinicians

Practice addresses (Care Compare)

4900 W Main St
Belleville, IL 62226-4725
Phone (618) 235-2400

Merit-based Incentive Payment System (MIPS)

Final score
89.84 of 100Reported as group
Quality
92.01
Improvement activities
40
Cost
76.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036092365ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JFJ Eyecare LTD CurrentSince Sep 1, 2014 Accepting new patients
JFJ Eyecare, LTD CurrentSince Sep 1, 2014 Accepting new patients

Locations

111 W Lincoln St
Belleville, IL 62220
Phone (618) 234-1774

4900 W Main St
Belleville, IL 62226
Phone (618) 235-2400

408 W 2nd St
Centralia, IL 62801
Phone (618) 532-5531

3990 N Illinois St
Swansea, IL 62226
Phone (618) 235-3100

Organizations & group practices 2

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1073509766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264725",
            "telephone_number": "618-235-2400",
            "fax_number": "618-235-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 N ILLINOIS ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261919",
            "telephone_number": "618-277-1130",
            "fax_number": "618-277-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEKOLA",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036092365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08215191",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "18007717",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092365",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

Verify at the official NPI Registry.