Individual provider Active NPI

Sheng Nan Yu, OD

  • Optometrist
  • Peoria, IL
National Provider Identifier
1356124549
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011754 Issued in IL
Practice address
6807 N Knoxville Ave
Peoria, IL 61614-2812
Phone
(309) 692-0000
Fax
(309) 692-8082
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011754 IL Primary

Addresses

Primary practice location

6807 N Knoxville Ave
Peoria, IL 61614-2812

Mailing address

6807 N Knoxville Ave
Peoria, IL 61614-2812
Phone (309) 692-0000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230828001497 IL Practitioner - Optometry 9032572862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bixby Eye Center IncGroup PAC ID 7012907892, 3 clinicians

Practice addresses (Care Compare)

6807 N Knoxville Ave
Peoria, IL 61614-2812
Phone (309) 692-0000

Merit-based Incentive Payment System (MIPS)

Final score
76.9 of 100Reported as group
Quality
53.81
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011754ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bixby Eye Center PC Optometrist CurrentSince Aug 14, 2023 Accepting new patients

Locations

6807 N Knoxville Ave
Peoria, IL 61614
Phone (309) 692-0000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1356124549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6807 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142812",
            "telephone_number": "309-692-0000",
            "fax_number": "309-692-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142812",
            "telephone_number": "309-692-0000",
            "fax_number": "309-692-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "SHENG NAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.