Krystina Lee Eubanks, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010566 Issued in IL

Practice address

960 S Commercial St
Harrisburg, IL 62946-2637

Phone

(618) 253-7057

Fax

(618) 252-1632

NPI assigned

Jul 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Harrisburg Medical Center Inc

  • General Acute Care Hospital
  • Harrisburg, IL
  • NPI 1073580130

  Corporate Director

  CMS ownership
• Harrisburg Medical Center Inc

  • Psychiatric Hospital Unit
  • Harrisburg, IL
  • NPI 1073581872

  Corporate Director

  CMS ownership
• Harrisburg Medical Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Harrisburg, IL
  • NPI 1093783896

  Corporate Director

  CMS ownership
• Harrisburg Medical Center Inc

  • Rural Health Clinic/Center
  • Marion, IL
  • NPI 1649795659

  Corporate Director

  CMS ownership

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.

• Eubanks & Daugherty, LLC

  • Optometrist
  • Harrisburg, IL
  • NPI 1902130354

  IL, Optometrist

  Medicare reassignment NPD
• Gregg Eubanks OD

  • Optometrist
  • Harrisburg, IL
  • NPI 1851305593
  NPD (past)

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1295099547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 S COMMERCIAL ST",
            "address_2": "PO BOX 488",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462637",
            "telephone_number": "618-253-7057",
            "fax_number": "618-252-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 S COMMERCIAL ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462637",
            "telephone_number": "618-253-7057",
            "fax_number": "618-252-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "KRYSTINA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Callis Ellis, BSN RN
• Empowerme Rehabilitation Illinois, LLC
• Ethan Grounds DMD PC
• Timothy Etienne, RPH
• Eubanks & Daugherty, LLC
• Matthew Blaine Eubanks, M.D.
• Melodi G Ewing, MD
• Family Healthcare Clinic & Rehab
• Fenton Dialysis LLC
• Ferrell Hospital Community Foundation

• All providers in Harrisburg, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.