Individual provider Active NPI

Andrew Joseph Milder, O.D.

  • Optometrist
  • Peoria, IL
National Provider Identifier
1194509554
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011782 Issued in IL
Practice address
4727 N Sheridan Rd
Peoria, IL 61614-5925
Phone
(309) 670-2020
NPI assigned
Aug 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011782 IL Primary

Addresses

Primary practice location

4727 N Sheridan Rd
Peoria, IL 61614-5925

Mailing address

4727 N Sheridan Rd
Peoria, IL 61614-5925
Phone (309) 670-2020

Other practice location 1

1009 N Cummings Ln
Washington, IL 61571-9646
Phone (309) 444-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231102001555 IL Practitioner - Optometry 1456707017 Reassigns benefits to 3 organizations
I20251003001618 IA Practitioner - Optometry 1456707017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Center PC 4 clinicians
MVC Vision 01 PLLC 3 clinicians

Practice addresses (Care Compare)

4727 N Sheridan Rd
Peoria, IL 61614-5925
Phone (309) 670-2020

6880 Ep True Pkwy
West Des Moines, IA 50266-5285
Phone (402) 933-7232

Merit-based Incentive Payment System (MIPS)

Final score
97 of 100Reported as group
Quality
94
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011782ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
MVC Vision 01 PLLC CurrentSince Sep 1, 2025 Accepting new patients
MVS Vision 02 PLLC CurrentSince Sep 1, 2025 Accepting new patients
Vision Care Center PC Optometrist CurrentSince Sep 16, 2023 Accepting new patients
Tazewell County Resource Centers Inc CurrentSince Jan 24, 2025 Accepting new patients
Tina R Thomas OD LTD Optometrist PastSince Sep 16, 2023 Accepting new patients

Locations

81A E Queenwood Rd
Morton, IL 61550
Phone (309) 266-9757

33 S 4th St
Pekin, IL 61554

4727 N Sheridan Rd
Peoria, IL 61614
Phone (309) 688-1345

1009 N Cummings Ln
Washington, IL 61571
Phone (309) 231-4134

16820 Frances St
Ste 100
Omaha, NE 68130
Phone (402) 933-6600

Organizations & group practices 6

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": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1194509554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145925",
            "telephone_number": "309-670-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145925",
            "telephone_number": "309-670-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 N Cummings Ln",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IL",
            "postal_code": "615719646",
            "country_code": "US",
            "telephone_number": "309-444-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILDER",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.