Andrew W. Backus, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-006702 Issued in IL

Practice address

6 Heartland Dr
Suite C
Bloomington, IL 61704-7736

Phone

(309) 663-0303

Fax

(309) 663-0161

NPI assigned

Aug 17, 2005

Reactivated

Mar 28, 2006

Last updated

Aug 11, 2014By 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 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

Indiana University - School of Optometry, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rieger Eyecare LTDGroup PAC ID 1153404066, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Rieger Eyecare LTD.

  • Optometrist
  • Normal, IL
  • NPI 1720276801
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1336131259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HEARTLAND DR STE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047737",
            "telephone_number": "309-663-0303",
            "fax_number": "309-663-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HEARTLAND DR",
            "address_2": "SUITE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047736",
            "telephone_number": "309-663-0303",
            "fax_number": "309-663-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKUS",
        "first_name": "ANDREW",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2014-08-11",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-006702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Axline Advanced
• Axline's Inc. (Axline Pharmacy (05))
• Pejman Babakhanlou, M.D.
• Imoleayo Taiwo Babarinde
• Alex Baca, LPC
• Kathleen Backus, MA, LCPC
• Amber Baer, BSN, RN
• Lisa Baer
• Alpha Bah, D.O.
• Ashley Lynn Marie Bailey

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.