NPIMap

Organization Active NPI

Marion Eye Centers LTD.

  • Durable Medical Equipment & Medical Supplies
  • Benton, IL
National Provider Identifier
1669537239
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
036051996 Issued in IL
Legal business name
MARION EYE CENTERS LTD.
Practice address
1102 N Main St
Benton, IL 62812-1022
Phone
(618) 439-2020
Fax
(618) 435-4730
NPI assigned
Dec 26, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Maqbool Ahmad, M.D.
Title
President Owner
Phone
(618) 993-5686

Corporate family (same tax ID) 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Marion Eye Centers LTD1102 N Main St, Benton, IL 62812-1022(618) 439-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100930091885 IL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 3072426774 Practice locations: Benton, IL

National Provider Directory

National Provider Directory
Tax ID family
Marion Eye Centers Inc (29 organizations share this tax ID)

Locations

1102 N Main St
Benton, IL 62812
Phone (618) 439-2020

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 036051996 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

1102 N Main St
Benton, IL 62812-1022

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
203169800MedicaidMO
036051996MedicaidIL

Other names 1

NPPES NPI Registry
  • Marion Eye Centers, Ltd. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2017.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502064000000",
    "number": "1669537239",
    "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": "1102 N MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121022",
            "telephone_number": "618-439-2020",
            "fax_number": "618-435-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION EYE CENTERS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2017-08-07",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MAQBOOL",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "618-993-5686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036051996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203169800",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051996",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Eye Centers, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.