NPIMap

Organization Active NPI

Pec Brighton PLLC

Doing business as Performance Eyecare

  • Optometrist
  • Brighton, IL
National Provider Identifier
1689490070
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PEC BRIGHTON PLLC
Doing business as
Performance Eyecare
Practice address
101 N Maple St
Brighton, IL 62012-1053
Phone
(618) 372-7000
NPI assigned
Dec 2, 2024
Last updated
Dec 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Pam Hark
Title
Insurance Manager
Phone
(618) 502-0255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

101 N Maple St
Brighton, IL 62012-1053

Mailing address

4111 N Illinois St
Swansea, IL 62226-7609
Phone (618) 502-0255

Other names 1

  • Performance Eyecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241231003200 IL Part B Supplier - Clinic/Group Practice 8022545102 Receives reassigned benefits from 4 practitioners
Practice locations: Brighton, IL

National Provider Directory

National Provider Directory

Locations

2865 Homer M Adams Pkwy
Alton, IL 62002
Phone (618) 223-6281

101 N Maple St
Brighton, IL 62012
Phone (618) 372-7000

466 Market St
Ste Genevieve, MO 63670
Phone (573) 883-2774

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1689490070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N ILLINOIS ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622267609",
            "telephone_number": "618-502-0255",
            "fax_number": "618-234-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MAPLE ST",
            "city": "BRIGHTON",
            "state": "IL",
            "postal_code": "620121053",
            "telephone_number": "618-372-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEC BRIGHTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "HARK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "618-502-0255"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.