Prairie Eye Center, LTD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PRAIRIE EYE CENTER, LTD

Practice address

518 Broadway St
Lincoln, IL 62656-2706

Phone

(217) 732-6062

Fax

(217) 732-8495

NPI assigned

Feb 17, 2021

Organization subpart

Yes

Parent organization

PRAIRIE EYE CENTER, LTDAs reported in NPPES

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

Authorized official

Name

Jason Lang

Title

Billing Administrator

Phone

(217) 698-3030

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Prairie Eye Center, LTD

  • Ophthalmology Physician
  • Springfield, IL
  • NPI 1447222864

  O20031111000811

  Same enrollment
• Prairie Eye Center, LTD

  • Ophthalmology Physician
  • Decatur, IL
  • NPI 1679166953

  O20031111000811

  Same enrollment

Part of

Eye Care Prof of Hillsb

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Prairie Eye Center, LTD

  • Ophthalmology Physician
  • Springfield, IL
  • NPI 1447222864
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander Remington Kane, OD

  • Optometrist
  • Springfield, IL
  • NPI 1336766377
  NPD
• Alex Brian Willis Jr., MD

  • Ophthalmology Physician
  • Springfield, IL
  • NPI 1316442288

  Ophthalmology

  NPD
• Jeffrey Montgomery, OD

  • Optometrist
  • Chesterfield, MO
  • NPI 1760431019
  NPD
• Abdulrahman Khamiss Rageh, MD

  • Ophthalmology Physician
  • McAllen, TX
  • NPI 1770070146

  Ophthalmology

  NPD
• Marc Christopher Sarmiento, O.D.

  • Optometrist
  • Springfield, IL
  • NPI 1932116449
  NPD (past)

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1366035644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044174",
            "telephone_number": "217-698-3030",
            "fax_number": "217-698-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 BROADWAY ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626562706",
            "telephone_number": "217-732-6062",
            "fax_number": "217-732-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE EYE CENTER, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRAIRIE EYE CENTER, LTD",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "217-698-3030"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Rose Pelfrey-Jones, O.D.
• Andrea Kay Perkins, FNP
• Pine Street Pharmacies
• Jessica Doreen Plummer, COTA
• Ronald James Pollett II, PT
• Clarence E Quint, CRNA
• Reflection Management
• Paul Rennick, D.C.
• Maria E. Rexroad, FNP-BC
• Mary Jo Reynolds, P.T

• All providers in Lincoln, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.