Individual provider Active NPI

Anthony Pete Tsiftilis, O.D.

  • Optometrist
  • Sycamore, IL
National Provider Identifier
1740305366
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008933 Issued in IL
Practice address
2127 Midlands CT.
Unit 101
Sycamore, IL 60178
Phone
(815) 756-4244
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 046-008933 IL
Optometrist 152W00000X 046-008933 IL Primary
Pediatric Optometrist 152WP0200X 046-008933 IL
Vision Therapy Optometrist 152WV0400X 046-008933 IL
Occupational Vision Optometrist 152WX0102X 046-008933 IL

Addresses

Primary practice location

2127 Midlands CT.
Unit 101
Sycamore, IL 60178

Mailing address

178 Quinlan Ave
Dekalb, IL 60115-8209
Phone (815) 739-5709

Other identifiers 1

IdentifierTypeStateIssuer
046-008933OtherILSTATE O.D. LICENSE NO.

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
I20110112000282 IL Practitioner - Optometry 6406045129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2127 Midlands CT
Suite 101
Sycamore, IL 60178-3173
Phone (815) 756-4244

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008933ILMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Q Vision, Inc Optometrist CurrentSince Nov 5, 2010 Accepting new patients
Miller Eye Center LTD Past Accepting new patients

Locations

2127 Midlands Ct
Unit 101
Sycamore, IL 60178
Phone (815) 756-4244

Organizations & group practices 2

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1740305366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 QUINLAN AVE",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601158209",
            "telephone_number": "815-739-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 MIDLANDS CT.",
            "address_2": "UNIT 101",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-756-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIFTILIS",
        "first_name": "ANTHONY",
        "middle_name": "PETE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046-008933",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008933",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IL",
            "license": "046-008933",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": "046-008933",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "IL",
            "license": "046-008933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE O.D. LICENSE NO.",
            "identifier": "046-008933",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.