Individual provider Active NPI

Matthew Charles Falconer, OD

  • Optometrist
  • Fairview Heights, IL
National Provider Identifier
1235865296
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011663 Issued in IL
Practice address
6407 N Illinois St
Fairview Heights, IL 62208-2720
Phone
(618) 398-5005
Fax
(618) 852-1930
NPI assigned
Aug 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011663 IL Primary

Addresses

Primary practice location

6407 N Illinois St
Fairview Heights, IL 62208-2720

Mailing address

6407 N Illinois St
Fairview Heights, IL 62208-2720
Phone (618) 398-5005

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
I20220819000168 IL Practitioner - Optometry 6901289297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reed Eye Care CenterGroup PAC ID 0840588760, 3 clinicians

Practice addresses (Care Compare)

10900 Lincoln TRL
Fairview Heights, IL 62208-2042

6407 N Illinois St
Fairview Heights, IL 62208-2720
Phone (618) 398-5005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011663ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Reed Eye Care Center Optometrist CurrentSince Nov 28, 2022 Accepting new patients
Associated Vision Care, LTD Optometrist CurrentSince Feb 8, 2023 Accepting new patients

Locations

6407 N Illinois St
Fairview Heights, IL 62208
Phone (618) 310-0263

10900 Lincoln Trl
Fairview Hts, IL 62208
Phone (618) 398-5005

1003 E Wesley Dr
Ste A
O Fallon, IL 62269
Phone (618) 624-3937

Organizations & group practices 2

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1235865296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6407 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082720",
            "telephone_number": "618-398-5005",
            "fax_number": "618-852-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6407 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082720",
            "telephone_number": "618-398-5005",
            "fax_number": "618-852-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCONER",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

Verify at the official NPI Registry.