Robert C Bobell, O.D.
Individual provider
Active NPI
Optometrist · Canton, IL
NPI 1104935923 · NPPES record last updated Aug 6, 2012
Key facts
- NPI
- 1104935923
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046008151 (IL)
- Practice address
- 42 N Main St
Canton, IL 61520-2623
- Phone
- (309) 647-2020
- Fax
- (309) 647-8944
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
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.
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Progressive Vision Center LTD (3 clinicians)
Practice addresses (Care Compare)
42 N Main St
Canton, IL 61520-2623
Phone (309) 647-2020
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100 (group)
- Quality
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|
| Cataract surgery | 35 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20100330000187 |
IL |
Practitioner - Optometry |
5799811709 |
Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|
| 046008151 | IL | MD | Optometrist |
Practice roles
Interoperability endpoints
- Direct secure messaging: drbobell@pvc2020.eyeclinicdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Optometrist |
152W00000X |
046008151 |
IL |
Yes |
Addresses
Primary practice location
42 N Main St
Canton, IL 61520-2623
Mailing address
42 N Main St
Canton, IL 61520-2623
Phone (309) 647-2020
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (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.