Michael Gerald Hoerres, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008302 Issued in IL

Practice address

704 Crosstown Ave
Silvis, IL 61282-1651

Phone

(309) 796-1444

Fax

(309) 796-1496

NPI assigned

Sep 16, 2005

Last updated

Dec 10, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacobsen Eye Care LLC

  • Optometrist
  • Silvis, IL
  • NPI 1992488613
  Medicare reassignment NPD

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1316932171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 CROSSTOWN AVE",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821651",
            "telephone_number": "309-796-1444",
            "fax_number": "309-796-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CROSSTOWN AVE",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612821651",
            "telephone_number": "309-796-1444",
            "fax_number": "309-796-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOERRES",
        "first_name": "MICHAEL",
        "middle_name": "GERALD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008302",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "152-01893",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08132052",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark D Gratton, P.T.
• Billy Guzman, MD
• Ian Hart, PA-C
• Fikru Heramo, MD, FACP
• Krystle Lee Hergert, RD, LD
• Sheila Holdren, LPN RDCS
• Ainsley Horack, OTR/L
• Brittney N Hughes, ARNP
• Hy-Vee Inc (Hy-Vee Pharmacy (1600))
• Illini Clinic Pharmacy Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.