NPIMap

Organization Active NPI

Marion Eye Centers LTD.

  • Ophthalmology Physician
  • Marion, IL
National Provider Identifier
1508865643
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-051996 Issued in IL
Legal business name
MARION EYE CENTERS LTD.
Practice address
1200 W Deyoung St
Marion, IL 62959-4437
Phone
(618) 993-5686
Fax
(618) 997-5595
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Authorized official

Name
Dr. Maqbool Ahmad
Title
President/Owner
Phone
(618) 993-3838

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 036-051996 IL
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 036-051996 IL Primary
Retina Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0107X 036.051996 IL

Addresses

Primary practice location

1200 W Deyoung St
Marion, IL 62959-4437

Mailing address

1200 W Deyoung St
P.O. Box 1178
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers 4

IdentifierTypeStateIssuer
791580195OtherMEDICARE RAILROAD
CA2196 GROUP PTANOtherILMEDICARE RAILROAD
036051996MedicaidIL
203169800MedicaidMO

Other names 1

  • Marion Eye Centers, Ltd. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031125000609 IL Part B Supplier - Clinic/Group Practice 3072426774 Receives reassigned benefits from 34 practitioners
Practice locations: Harrisburg, IL; Herrin, IL; Marion, IL; MC Leansboro, IL; Mount Vernon,, IL; Murphysboro, IL; Nashville, IL; Olney, IL…
O20040319000260 MO Part B Supplier - Clinic/Group Practice 3072426774 Receives reassigned benefits from 14 practitioners
Practice locations: Cape Girardeau, MO; Sikeston, MO; Poplar Bluff, MO; Dexter, MO; Charleston, MO

National Provider Directory

National Provider Directory

Locations

374 E Grand Ave
Carbondale, IL 62901
Phone (618) 453-1292

1001 N Beadle Dr
Ste 10
Carbondale, IL 62901

374 E Grand Ave
Rm 140A
Carbondale, IL 62901

1201 W Main St
Carmi, IL 62821
Phone (618) 384-5112

203 Van Zant St
Chester, IL 62233
Phone (618) 826-5413

821 S Washington St
Du Quoin, IL 62832
Phone (618) 542-3812

600 N Keller Dr
#A
Effingham, IL 62401
Phone (217) 342-2900

600 N Keller Dr
Effingham, IL 62401
Phone (217) 342-2900

600 N Keller Dr
Ste A
Effingham, IL 62401
Phone (217) 342-2900

1200 E Deyoung St
Marion, IL 62959

1801 E 5th St
#890
Metropolis, IL 62960
Phone (800) 851-3601

1801 E 5th St
Metropolis, IL 62960
Phone (618) 524-9323

2900 Broadway St
Mount Vernon, IL 62864
Phone (618) 244-2777

902 E Locust St
Olney, IL 62450
Phone (618) 392-2020

216 N Market St
Sparta, IL 62286
Phone (601) 443-2020

307 W Broadway
Steeleville, IL 62288
Phone (618) 965-2020

1003 W Vine St
Ste C
Vienna, IL 62995
Phone (618) 658-2195

909 W Main St
West Frankfort, IL 62896
Phone (618) 372-6040

117 E N Main St
Dexter, MO 63841

212 S Main St
Sikeston, MO 63801
Phone (573) 472-8181

Practitioners & affiliated clinicians

Practitioners 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501459200000",
    "number": "1508865643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "address_2": "P.O. BOX 1178",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION EYE CENTERS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2017-07-31",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MAQBOOL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "618-993-3838",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "036-051996",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-051996",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036.051996",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "791580195",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CA2196 GROUP PTAN",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051996",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203169800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Eye Centers, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; 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.