Organization Active NPI

Rieger Eyecare LTD.

  • Optometrist
  • Normal, IL
National Provider Identifier
1720276801
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008997 Issued in IL
Legal business name
RIEGER EYECARE LTD.
Practice address
407 Kays Dr Ste a
Normal, IL 61761-1958
Phone
(309) 454-1010
Fax
(309) 454-1077
NPI assigned
Oct 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Authorized official

Name
Dr. Mary Teresa Rieger, O.D.NPI 1770572620
Title
Optometrist
Phone
(309) 454-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046-008997 IL Primary

Addresses

Primary practice location

407 Kays Dr Ste a
Normal, IL 61761-1958

Mailing address

407 Kays Dr Ste a
Normal, IL 61761-1958
Phone (309) 454-1010

Other identifiers 2

IdentifierTypeStateIssuer
5732151OtherILBLUE CROSS BLUE SHIELD
046008997MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080215000439 IL Part B Supplier - Clinic/Group Practice 1153404066 Receives reassigned benefits from 3 practitioners
Practice locations: Normal, IL

National Provider Directory

National Provider Directory

Locations

2409 E Washington St
Ste 1
Bloomington, IL 61704
Phone (309) 663-8581

407 Kays Dr
#A
Normal, IL 61761
Phone (309) 454-1010

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1720276801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 KAYS DR STE A",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611958",
            "telephone_number": "309-454-1010",
            "fax_number": "309-454-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 KAYS DR STE A",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611958",
            "telephone_number": "309-454-1010",
            "fax_number": "309-454-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIEGER EYECARE LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-14",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "RIEGER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "309-454-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5732151",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008997",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.