Individual provider Active NPI

Nicole Lowrey, MD, PHD

  • Ophthalmology Physician
  • O'Fallon, IL
National Provider Identifier
1356902381
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2019018196 Issued in MO
Practice address
705 Insight Ave
O Fallon, IL 62269-2146
Phone
(618) 391-1660
Fax
(618) 861-6003
NPI assigned
Jun 20, 2019
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2019018196 MO Primary
Ophthalmology Physician 207W00000X 036166546 IL

Addresses

Primary practice location

705 Insight Ave
O Fallon, IL 62269-2146

Mailing address

705 Insight Ave
O Fallon, IL 62269-2146
Phone (618) 391-1660

Other practice location 1

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Other practice location 2

1 Professional Dr Ste 260
Alton, IL 62002-5068
Phone (618) 391-1660

Other practice location 3

12400 Olive Blvd Ste 200
Saint Louis, MO 63141-5436
Phone (314) 391-9400

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
I20230912001619 IL Practitioner - Ophthalmology 9739415944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Southwestern Medical School at Dallas, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Eye Surgery LLCGroup PAC ID 7315200888, 13 clinicians

Practice addresses (Care Compare)

705 Insight Ave
O Fallon, IL 62269-2146
Phone (618) 391-1660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.67 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.25

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery448

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036166546ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Eye Surgery LLC Multi-Specialty CurrentSince Oct 1, 2023 Accepting new patients
Retina Consultants, LLC Multi-Specialty PastSince Oct 1, 2023 Accepting new patients

Locations

1 Professional Dr
Ste 260
Alton, IL 62002
Phone (314) 921-2020

400 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-6402

250 E Elm St
Nashville, IL 62263
Phone (618) 327-3231

705 Insight Ave
O Fallon, IL 62269
Phone (618) 738-0337

12400 Olive Blvd
Saint Louis, MO 63141
Phone (314) 391-9400

12400 Olive Blvd
Ste 200
Saint Louis, MO 63141
Phone (314) 391-9400

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1356902381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692146",
            "telephone_number": "618-391-1660",
            "fax_number": "618-861-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692146",
            "telephone_number": "618-391-1660",
            "fax_number": "618-861-6003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Maple Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620522028",
            "country_code": "US",
            "telephone_number": "618-498-6402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Professional Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620025068",
            "country_code": "US",
            "telephone_number": "618-391-1660",
            "fax_number": "618-861-6003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12400 Olive Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631415436",
            "country_code": "US",
            "telephone_number": "314-391-9400",
            "fax_number": "618-861-6003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOWREY",
        "first_name": "NICOLE",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2019018196",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036166546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.