Gregory Macagba, OD
Individual provider Active NPI Optometrist · Manteno, IL
NPI 1487130274 · NPPES record last updated Jul 14, 2018
Key facts
- NPI
- 1487130274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046011210 (IL)
- Practice address
- 501 S Locust St
Manteno, IL 60950-1654 - Phone
- (815) 468-2015
- Fax
- (815) 468-2013
- NPI assigned
- Jul 14, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fisher-Gentry Eye Care PC
Practice addresses (Care Compare)
501 S Locust St
Manteno, IL 60950-1654
Phone (815) 468-2015
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180829000750 | IL | Practitioner - Optometry | 2264782093 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fisher-Gentry Eye Care PC | Optometrist | Current |
Accepting new patients |
Locations
501 S Locust St
Manteno, IL 60950
Phone (815) 468-2015
501 S Locust St
Ste 2
Manteno, IL 60950
Phone (815) 468-2015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046011210 | IL | Yes |
Addresses
Primary practice location
501 S Locust St
Manteno, IL 60950-1654
Mailing address
3832 Morgan TRL
Bourbonnais, IL 60914-4717
Phone (815) 212-0290
Other providers in Manteno, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.