Active NPI
Trevor Ray Crabtree, O.D.
- Optometrist
- Marion, IL
National Provider Identifier
1770575284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 047-207399
- Practice address
- 1508 Sioux Dr
Marion, IL 62959-5209 - Phone
- (618) 993-8787
- Fax
- (618) 997-6547
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 047-207399 | IL | Primary |
Addresses
Primary practice location
1508 Sioux Dr
Marion, IL 62959-5209
Mailing address
1508 Sioux Dr
Marion, IL 62959-5209
Phone (618) 993-8787
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110214000907 | IL | Practitioner - Optometry | 3577678184 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crabtree Family Optometry
Practice addresses (Care Compare)
1508 Sioux Dr
Marion, IL 62959-5200
Phone (618) 993-8787
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047-207399 | IL | MD | Optometrist |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770575284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 SIOUX DR",
"city": "MARION",
"state": "IL",
"postal_code": "629595209",
"telephone_number": "618-993-8787",
"fax_number": "618-997-6547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 SIOUX DR",
"city": "MARION",
"state": "IL",
"postal_code": "629595209",
"telephone_number": "618-993-8787",
"fax_number": "618-997-6547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRABTREE",
"first_name": "TREVOR",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "047-207399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.