Individual provider Active NPI

Robert Mathew Becker, OD

  • Optometrist
  • Morton, IL
National Provider Identifier
1114934965
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002632 Issued in CT
Practice address
155 E Courtland St
Morton, IL 61550-8931
Phone
(309) 263-6747
Fax
(309) 263-6744
NPI assigned
Aug 2, 2006
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002632 CT Primary
Optometrist 152W00000X 046010410 IL

Addresses

Primary practice location

155 E Courtland St
Morton, IL 61550-8931

Mailing address

6135 S Greenwood Ave Apt 3S
Chicago, IL 60637-2721
Phone (203) 687-6531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140902001129 NY Practitioner - Optometry 0446232847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehsoc IncGroup PAC ID 3779530407, 4 clinicians

Practice addresses (Care Compare)

2901 Court St
Syracuse, NY 13208-3217
Phone (315) 455-8933

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010410ILMDOptometrist
007811NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Connecticut Professional PLLC Optometrist PastSince May 5, 2024 Accepting new patients
Ehsoc Optometrist Past Accepting new patients
Philip M Perrino P.C. Optometrist Past Accepting new patients

Organizations & group practices 4

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1114934965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 S GREENWOOD AVE APT 3S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372721",
            "telephone_number": "203-687-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E COURTLAND ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615508931",
            "telephone_number": "309-263-6747",
            "fax_number": "309-263-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "ROBERT",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002632",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.