Individual provider Active NPI

Clifford Earl Myers, M.D.

  • Ophthalmology Physician
  • Peoria, IL
National Provider Identifier
1356320253
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-060306 Issued in IL
Practice address
5401 N Knoxville Ave
Suite 106
Peoria, IL 61614-5098
Phone
(309) 693-2710
Fax
(309) 693-9460
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036-060306 IL Primary

Addresses

Primary practice location

5401 N Knoxville Ave
Suite 106
Peoria, IL 61614-5098

Mailing address

8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-2400

Other identifiers 1

IdentifierTypeStateIssuer
1356320253MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060324000179 IL Practitioner - Ophthalmology 7315955895 Reassigns benefits to 1 organization
Practice locations: Peoria, IL

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyman Sicher Eye Associates SCGroup PAC ID 7911965801, 20 clinicians

Practice addresses (Care Compare)

8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-2400

Merit-based Incentive Payment System (MIPS)

Final score
90.67 of 100Reported as group
Quality
95.34
Promoting interoperability
100
Improvement activities
40
Cost
73.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-060306ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyman Sicher Eye Associates SC Ophthalmology CurrentSince Jan 1, 2020 Accepting new patients
Wyman Sicher Eye Associates SC Ophthalmology CurrentSince Jan 1, 2020 Accepting new patients

Locations

8921 N Wood Sage Rd
Peoria, IL 61615
Phone (309) 243-2400

Interoperability endpoints

  • Direct secure messaging: direct@illinoiseyecenterpeoriail.compulinkdirect.com

Organizations & group practices 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1356320253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 106",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-693-2710",
            "fax_number": "309-693-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CLIFFORD",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2021-10-19",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-060306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356320253",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com",
            "affiliation": "N",
            "endpointDescription": "CCD only, does not accept attachments",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8921 N Wood Sage Rd",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616157822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.