Individual provider Active NPI

Wilson W. Movic, O.D.

  • Optometrist
  • Bloomington, IL
National Provider Identifier
1194730648
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-007251 Issued in IL
Practice address
2103 E Washington St
Bloomington, IL 61701-4310
Phone
(309) 662-2277
Fax
(309) 663-6472
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-007251 IL Primary

Addresses

Primary practice location

2103 E Washington St
Bloomington, IL 61701-4310

Mailing address

2103 E Washington St
Bloomington, IL 61701-4310
Phone (309) 662-2277

Other identifiers 2

IdentifierTypeStateIssuer
046007251MedicaidIL
0005784008OtherILBCBS

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
I20081001000462 IL Practitioner - Optometry 6406924638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionpoint Eye Center LLCGroup PAC ID 0749522092, 15 clinicians

Practice addresses (Care Compare)

1107 Airport Rd
Bloomington, IL 61704-2544
Phone (309) 662-7700

Merit-based Incentive Payment System (MIPS)

Final score
91.11 of 100Reported as group
Quality
97.66
Improvement activities
40
Cost
73.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-007251ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionpoint Eye Center LLC Optometrist CurrentSince May 1, 2019 Accepting new patients

Locations

1107 Airport Rd
Bloomington, IL 61704
Phone (309) 662-7700

Organizations & group practices 1

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1194730648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 E WASHINGTON ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014310",
            "telephone_number": "309-662-2277",
            "fax_number": "309-663-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 E WASHINGTON ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014310",
            "telephone_number": "309-662-2277",
            "fax_number": "309-663-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOVIC",
        "first_name": "WILSON",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007251",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0005784008",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.