Individual provider Active NPI

Robert M Quilleash

  • Corneal and Contact Management Optometrist
  • Peoria, IL
National Provider Identifier
1174717003
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
046009163 Issued in IL
Practice address
2200 W War Memorial Dr
Pearle Vision
Peoria, IL 61613-1000
Phone
(309) 688-2161
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 046009163 IL Primary

Addresses

Primary practice location

2200 W War Memorial Dr
Pearle Vision
Peoria, IL 61613-1000

Mailing address

2200 W War Memorial Dr
Peoria, IL 61613-1000
Phone (309) 688-2161

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
I20120823000395 IL Practitioner - Optometry 8729235957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.19 of 100Reported as group
Quality
99.36
Improvement activities
40
Cost
44.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009163ILMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gailey Eye Clinic, LTD CurrentSince Jul 10, 2017 Accepting new patients
Gailey Eye Clinic, LTD Current Accepting new patients
Gailey Eye Clinic, LTD CurrentSince Jul 10, 2017 Accepting new patients
Gailey Eye Clinic, LTD Past Accepting new patients
Pearle Vision Inc Past Accepting new patients

Locations

1008 N Main St
Bloomington, IL 61701
Phone (309) 829-5311

834 N Seminary St
Ste 103
Galesburg, IL 61401
Phone (309) 343-6000

Interoperability endpoints

  • Direct secure messaging: robert.quilleash.p1@direct.gec.nextgenshare.com

Organizations & group practices 5

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1174717003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W WAR MEMORIAL DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616131000",
            "telephone_number": "309-688-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W WAR MEMORIAL DR",
            "address_2": "PEARLE VISION",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616131000",
            "telephone_number": "309-688-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLEASH",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046009163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.