Tim a Bengtson O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007904 Issued in IL

Legal business name

TIM A BENGTSON O.D., P.C.

Practice address

820 E Jackson St
Macomb, IL 61455-2412

Phone

(309) 833-4242

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Tim BengtsonNPI 1891989919

Title

Owner

Phone

(309) 833-4242

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tim A Bengtson, O.D.

  • Optometrist
  • Macomb, IL
  • NPI 1891989919
  Medicare reassignment Care Compare group NPD Authorized official
• Hannah Lauren Bengtson, O.D.

  • Optometrist
  • Macomb, IL
  • NPI 1780154013
  Medicare reassignment Care Compare group NPD
• Brigette Anne Colley, O.D.

  • Optometrist
  • Macomb, IL
  • NPI 1992147086
  Medicare reassignment Care Compare group NPD
• Brooke Danielle Tobias, OD

  • Optometrist
  • Indianapolis, IN
  • NPI 1427628668

  IL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1285646661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552412",
            "telephone_number": "309-833-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM A BENGTSON O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "BENGTSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-833-4242"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007904",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0005584005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Solutions of Macomb LLC
• Andrea Ruth Thompson, MS, RD, LDN
• Mary C Thompson, CNM
• Jessica L Thorman, FNP-C
• Bria Thurman
• Kevin Traser, PHARM.D.
• Trinity Speech Services LLC
• Scott Eric Urch, M.D.
• Connie Jo Ussery
• Terry Vail, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.