Individual provider Active NPI

Michael Morris

  • Optometrist
  • Mattoon, IL
National Provider Identifier
1083701718
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
101 Dettro Dr
Mattoon, IL 61938-9044
Phone
(217) 235-6855
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

101 Dettro Dr
Mattoon, IL 61938-9044

Mailing address

101 Dettro Dr
Mattoon, IL 61938-9044

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031224000068 IL Practitioner - Optometry 0749188910 Reassigns benefits to 1 organization
Practice locations: Effingham, IL; Robinson, IL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vep Il Optometric LLCGroup PAC ID 3678814217, 27 clinicians

Practice addresses (Care Compare)

1001 Charleston Ave E
Mattoon, IL 61938-6226
Phone (217) 235-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046008920ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vep Il Optometric LLC Optometrist CurrentSince Apr 18, 2024 Accepting new patients
Oneopto Il 2 PLLC Optometrist PastSince Sep 28, 2025 Accepting new patients

Locations

101 N Veterans Pkwy
Ste 301
Bloomington, IL 61704
Phone (309) 663-2700

1001 Charleston Ave E
Mattoon, IL 61938
Phone (217) 235-2020

811 Main St
Kansas City, MO 64180

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083701718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DETTRO DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DETTRO DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389044",
            "telephone_number": "217-235-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.