Tina Renee Thomas, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008635 Issued in IL

Practice address

8921 N Wood Sage Rd
Peoria, IL 61615-7822

Phone

(309) 243-2400

Fax

(309) 243-7918

NPI assigned

Jul 18, 2005

Sex

Female

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 2

Electronic endpoints 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, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wyman Sicher Eye Associates SCGroup PAC ID 7911965801, 20 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.67 of 100Reported as group

Quality

95.34

Promoting interoperability

100

Improvement activities

40

Cost

73.56

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@illinoiseyecenterpeoriail.compulinkdirect.com

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.

• Wyman Sicher Eye Associates SC

  • Ophthalmology Physician
  • Peoria, IL
  • NPI 1679593123
  Medicare reassignment Care Compare group NPD
• Wyman Sicher Eye Associates SC

  • Eyewear Supplier
  • Pekin, IL
  • NPI 1114537123

  Optometrist

  NPD
• Dennis M Brtva

  • Optometrist
  • Peoria, IL
  • NPI 1336112804
  NPD (past)
• Tazewell County Resource Centers Inc

  • Low Vision Rehabilitation Optometrist
  • East Peoria, IL
  • NPI 1265431506
  NPD (past)
• Vision Care Center PC

  • Optometrist
  • Peoria, IL
  • NPI 1043291677
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1285633693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-3869",
            "fax_number": "309-243-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TINA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008635",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09030205",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com",
            "affiliation": "N",
            "endpointDescription": "accepts CCD only- does not accept attachments",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8921 N Wood Sage Rd",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616157822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathy Ann Thomas, MSW
• Kayla Thomas, DO
• Nyashia Thomas
• Sachdev P Thomas, MD
• Stephanie Lynn Thomas, RD, CD
• Glen D. Thompson, DMD
• Jennifer N Thompson, M.D.
• Jeremiah James Thompson, D.C.
• Kaylee Thompson
• Kristen Thompson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.