Mark D Hahn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

04600009257 Issued in IL

Practice address

8 Cherry Tree Center
Washington, IL 61571-2170

Phone

(309) 444-2277

Fax

(309) 444-2498

NPI assigned

Sep 30, 2005

Sex

Male

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 3

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J a K Enterprises IncGroup PAC ID 3173519014, 24 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• J a K Enterprises Inc

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1508856923

  Optometrist

  Medicare reassignment Care Compare group NPD
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Litchfield, IL
  • NPI 1205663499

  Optometrist

  NPD
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Pontiac, IL
  • NPI 1255617924

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Peoria, IL
  • NPI 1376581611

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Moline, IL
  • NPI 1790723542

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388793600000",
    "number": "1528055969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540",
            "fax_number": "309-693-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CHERRY TREE CENTER",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712170",
            "telephone_number": "309-444-2277",
            "fax_number": "309-444-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2014-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "04600009257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009257",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410043928",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7215175",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Jo Green
• Kelsey Gundy, M.A. CCC-SLP
• Kortney M Haage, OT
• Marilyn Haerr, COTA/L
• Laura Hagan, PT
• David Hall
• Jonathan Hamm, PT
• Michele Lee Heinz, MS SLP CCC
• James F. Hensold, M.D.
• Michael John Herman, DDS

• Optometrist in Washington, IL
• Providers in Washington, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2014; 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.