Anna Michelle Edmiston, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036.146283 Issued in IL

Practice address

300 N Milwaukee Ave Ste L
Lake Villa, IL 60046

Phone

(847) 356-0700

NPI assigned

May 19, 2014

Last updated

Jul 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

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 2

Specialty

Ophthalmology

Education

University of Alabama School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plano Vision PLLCGroup PAC ID 9335633528, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Plano Vision PLLC

  • Ophthalmology Physician
  • Plano, TX
  • NPI 1598536344
  Medicare reassignment Care Compare group NPD
• RLR Vision PLLC

  • Ophthalmology Physician
  • Oklahoma City, OK
  • NPI 1851977755
  Medicare reassignment NPD
• Plano Eye Care Surgery Center PLLC

  • Ambulatory Surgical Clinic/Center
  • Plano, TX
  • NPI 1568227973
  NPD

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1386055762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N MILWAUKEE AVE STE L",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600468563",
            "telephone_number": "847-356-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MILWAUKEE AVE STE L",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-356-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Aurora Ct",
            "address_2": "F731",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452517",
            "country_code": "US",
            "telephone_number": "720-848-5029",
            "fax_number": "720-848-4043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMISTON",
        "first_name": "ANNA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.146283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "036.146283",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose B De Los Reyes, DMD
• Kristine Sue Decant, DPT, NCS
• Jigisha Desai, PHARM D
• Jacklyn Louise Durnil, M.S., CCC-SLP
• Kelly Nichole Eckhart, APRN
• Embrace Behavioral Health
• Elizabeth Ericksen, LPC
• Eugene Pomeranets M.D.S.C.,
• Family Care of Lake County S.C.
• Joel Keith Fish, D.C.

• Ophthalmology Physician in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.