Lisa S Keller, O.D.
Individual provider Active NPI Optometrist · Litchfield, IL
NPI 1164675989 · NPPES record last updated Oct 23, 2008
Key facts
- NPI
- 1164675989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046.010168 (IL)
- Practice address
- 1205 W Ferdon St
Litchfield, IL 62056-4454 - Phone
- (217) 324-5004
- Fax
- (217) 324-5438
- NPI assigned
- Oct 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1205 W Ferdon St
Litchfield, IL 62056-4454
Phone (217) 324-5004
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 62 |
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
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101230000877 | IL | Practitioner - Optometry | 2062600331 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.010168 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lisa S Keller OD Inc | Current |
Accepting new patients |
Locations
1205 W Ferdon St
Litchfield, IL 62056
Phone (217) 324-5004
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.010168 | IL | Yes |
Addresses
Primary practice location
1205 W Ferdon St
Litchfield, IL 62056-4454
Mailing address
1205 W Ferdon St
Litchfield, IL 62056-4454
Phone (217) 324-5004
Other providers in Litchfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2008. 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.
- 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.