Jeffrey T Caron, P.C.
Individual provider Active NPI Optometrist · Genoa, IL
NPI 1194701490 · NPPES record last updated Oct 5, 2010
Key facts
- NPI
- 1194701490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046008157 (IL)
- Practice address
- 318 W Main St
Genoa, IL 60135-5402 - Phone
- (815) 784-6480
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Marengo Vision Center, P.C.
Practice addresses (Care Compare)
205 N State St
Marengo, IL 60152-2239
Phone (815) 568-6508
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 |
|---|---|---|---|---|
| I20101012001255 | IL | Practitioner - Optometry | 2365558897 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046008157 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marengo Vision Center, P.C. | Optometrist | Current |
Accepting new patients |
| Marengo Vision Center, P.C. | Optometrist | Current |
Accepting new patients |
Locations
205 N State St
Marengo, IL 60152
Phone (815) 568-6508
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046008157 | IL | Yes |
Addresses
Primary practice location
318 W Main St
Genoa, IL 60135-5402
Mailing address
318 W Main St
Genoa, IL 60135-5402
Phone (815) 784-6480
Other providers in Genoa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2010. 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.