Dennis M Brtva, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-007731 Issued in IL

Practice address

1015 S Mercer Ave
Bloomington, IL 61701-7107

Phone

(309) 213-9200

Fax

(309) 213-9300

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allied Vision Source LLCGroup PAC ID 4486964665, 6 clinicians

Central Illinois Family Eyecare LLCGroup PAC ID 6204111644, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central Illinois Family Eyecare LLC

  dba Bloomington Eye Professionals

  • Optometrist
  • Bloomington, IL
  • NPI 1881135853
  Medicare reassignment Care Compare group Authorized official
• Allied Vision Source, LLC

  • Optometrist
  • Decatur, IL
  • NPI 1861860363
  Medicare reassignment Care Compare group NPD
• Dennis M Brtva

  dba Dr Dennis M Brtva & Associates

  • Optometrist
  • Peoria, IL
  • NPI 1336112804
  NPD (past) Authorized official
• Dennis M Brtva

  dba Dr Dennis M Brtva & Associates

  • Optometrist
  • Bloomington, IL
  • NPI 1730151572
  NPD (past) Authorized official
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1215909056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S MERCER AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017107",
            "telephone_number": "309-213-9200",
            "fax_number": "309-213-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S MERCER AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017107",
            "telephone_number": "309-213-9200",
            "fax_number": "309-213-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRTVA",
        "first_name": "DENNIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007731",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kynan Alexander Brown
• Robert D Brown, DC
• Daniel Douglas Brownstone, MD
• Brenda Broy
• Peter John Brozenec, R.PH.
• Edmond Bruce, RPT
• Jessica Bruin, D.C.
• William G Brunner, M.S., L.C.P.C.
• Rachel Buchler
• Patricia A Buckley, P.T.

• Optometrist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.