Individual provider Active NPI

Holly Regel, OD

  • Optometrist
  • O'Fallon, IL
National Provider Identifier
1679144067
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011540 Issued in IL
Practice address
735 Insight Ave
O Fallon, IL 62269-2193
Phone
(618) 628-2903
Fax
(618) 628-2913
NPI assigned
Jul 7, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011540 IL Primary

Addresses

Primary practice location

735 Insight Ave
O Fallon, IL 62269-2193

Mailing address

735 Insight Ave
O Fallon, IL 62269-2193
Phone (618) 628-2903

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
I20210726001298 IL Practitioner - Optometry 0941603195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Care of Ofallon PCGroup PAC ID 6204926843, 5 clinicians

Practice addresses (Care Compare)

735 Insight Ave
O Fallon, IL 62269-2193
Phone (618) 628-2903

Merit-based Incentive Payment System (MIPS)

Final score
83.18 of 100Reported as group
Quality
66.35
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011540ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Care of Ofallon PC Optometrist CurrentSince Jul 14, 2021 Accepting new patients

Locations

735 Insight Ave
O Fallon, IL 62269
Phone (618) 628-2903

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1679144067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692193",
            "telephone_number": "618-628-2903",
            "fax_number": "618-628-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692193",
            "telephone_number": "618-628-2903",
            "fax_number": "618-628-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGEL",
        "first_name": "HOLLY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.