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.
Doing business as
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
Last updated
Jul 31, 2017By the provider in NPPES
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 AhmadNPI 1699768911
Title
President/Owner
Phone
(618) 993-3838

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

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 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

165 Plaza Dr
Anna, IL 62906
Phone (618) 833-8359

1001 N Beadle Dr
Carbondale, IL 62901
Phone (618) 457-2123

1001 N Beadle Dr
Ste 10
Carbondale, IL 62901

374 E Grand Ave
#269
Carbondale, IL 62901
Phone (618) 549-0615

374 E Grand Ave
Rm 140A
Carbondale, IL 62901

404 E Plaza Dr
Carterville, IL 62918
Phone (618) 985-9983

899 E McCord St
Centralia, IL 62801
Phone (618) 532-1997

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

1204 US Highway 45 N
Eldorado, IL 62930
Phone (618) 273-6220

5 Eye Center Dr
Harrisburg, IL 62946
Phone (618) 252-5377

1200 E Deyoung St
Marion, IL 62959

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

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

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

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

117 N Main St
Charleston, MO 63834
Phone (573) 683-2020

297 S Silver Springs Rd
Cpe Girardeau, MO 63703
Phone (573) 651-5200

117 E N Main St
Dexter, MO 63841

1207 N One Mile Rd
Dexter, MO 63841
Phone (573) 624-4584

2511 N Westwood Blvd
Poplar Bluff, MO 63901
Phone (573) 686-5866

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

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": [],
    "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.