Individual provider Active NPI

Kelli E Cadion Crago, OD

  • Optometrist
  • O Fallon, IL
National Provider Identifier
1386752681
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009337 Issued in IL
Practice address
735 Insight Ave
O Fallon, IL 62269-2193
Phone
(618) 628-2903
Fax
(618) 628-2913
NPI assigned
Aug 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009337 IL Primary

Addresses

Primary practice location

735 Insight Ave
O Fallon, IL 62269-2193

Mailing address

852 Cambridge Boulevard
Suite 200
Ofallon, IL 62269
Phone (618) 628-2903

Other identifiers 2

IdentifierTypeStateIssuer
0040030308OtherILBCBS
2327858OtherILUNITED HEALTHCARE

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
I20101216000715 IL Practitioner - Optometry 6709074875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Care of Ofallon PCGroup PAC ID 6204926843, 5 clinicians

Practice addresses (Care Compare)

735 Insight Ave
O Fallon, IL 62269-2193
Phone (618) 628-2903

Merit-based Incentive Payment System (MIPS)

Final score
83.18 of 100Reported as group
Quality
66.35
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Care of Ofallon PC Optometrist CurrentSince Jul 1, 2003 Accepting new patients
Leonard Hughes Co Inc Past Accepting new patients
Leonard Hughes Co Inc Optometrist Past Accepting new patients
Associated Foot Surgeons of Southwest Illinois, LTD. Past Accepting new patients

Locations

852 Cambridge Blvd
Ste 200
O Fallon, IL 62269
Phone (618) 277-5700

735 Insight Ave
O Fallon, IL 62269
Phone (618) 628-2903

Interoperability endpoints

  • Direct secure messaging: kelli.cadion-crago@direct.revolutionehr.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FIBADD

Organizations & group practices 4

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": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1386752681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 CAMBRIDGE BOULEVARD",
            "address_2": "SUITE 200",
            "city": "OFALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-628-2903",
            "fax_number": "618-628-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692193",
            "telephone_number": "618-628-2903",
            "fax_number": "618-628-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADION CRAGO",
        "first_name": "KELLI",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0040030308",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2327858",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.