Individual provider Active NPI

Thomas L Mahaffey, OD

  • Optometrist
  • Bloomington, IL
National Provider Identifier
1669401139
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008812 Issued in IL
Practice address
1107 Airport Rd
Bloomington, IL 61704-2544
Phone
(309) 662-3937
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008812 IL Primary

Addresses

Primary practice location

1107 Airport Rd
Bloomington, IL 61704-2544

Mailing address

1107 Airport Rd
Bloomington, IL 61704-2544
Phone (309) 353-6660

Other identifiers 1

IdentifierTypeStateIssuer
046008812MedicaidIL

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
I20090506000373 IL Practitioner - Optometry 0749338481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionpoint Eye Center LLCGroup PAC ID 0749522092, 15 clinicians

Practice addresses (Care Compare)

1107 Airport Rd
Bloomington, IL 61704-2544
Phone (309) 662-7700

Merit-based Incentive Payment System (MIPS)

Final score
91.11 of 100Reported as group
Quality
97.66
Improvement activities
40
Cost
73.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gailey Eye Clinic, LTD CurrentSince Mar 29, 2018 Accepting new patients
Gailey Eye Clinic, LTD CurrentSince Mar 29, 2018 Accepting new patients
Gailey Eye Clinic, LTD Current Accepting new patients
Visionpoint Eye Center LLC Optometrist CurrentSince Jun 15, 2019 Accepting new patients
Bond Eye Associates, S.C. Past Accepting new patients
Alliance Eyecare, Inc. Optometrist Past Accepting new patients

Locations

1008 N Main St
Bloomington, IL 61701
Phone (309) 829-5311

1107 Airport Rd
Bloomington, IL 61704
Phone (309) 662-7700

Interoperability endpoints

  • Direct secure messaging: thomas.mahaffey.p1@direct.bondeye.nextgenshare.com

Organizations & group practices 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1669401139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 AIRPORT RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042544",
            "telephone_number": "309-353-6660",
            "fax_number": "309-353-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 AIRPORT RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042544",
            "telephone_number": "309-662-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAFFEY",
        "first_name": "THOMAS",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008812",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.