Ivetta S Daccache, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009676 Issued in IL

Practice address

725 S 14TH St
Pekin, IL 61554-5073

Phone

(309) 353-6660

NPI assigned

Sep 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Merit-based Incentive Payment System (MIPS)

Final score

97.5 of 100Reported as group

Quality

93.83

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: ivetta.daccache.p1@direct.bondeye.nextgenshare.com

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.

• Bond Eye Associates, SC

  • Ophthalmology Physician
  • Pekin, IL
  • NPI 1285725903

  Optometrist

  Medicare reassignment NPD
• Kerry Howard Head, OD

  • Optometrist
  • Kewanee, IL
  • NPI 1902993652
  Medicare reassignment
• Bond Eye Associates, S.C.

  • Optician
  • Canton, IL
  • NPI 1104025485
  NPD (past)
• J a K Enterprises Inc

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1508856923

  Optometrist

  NPD (past)
• Curators of the University of Missouri

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1790772143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S 14TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615545073",
            "telephone_number": "309-353-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S 14TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615545073",
            "telephone_number": "309-353-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACCACHE",
        "first_name": "IVETTA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009676",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7215175",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina I Crawford, RN
• Emily Crebo, FNP
• Crossroads Programs, Inc.
• Dennis Jay Crowell, MSW, LCSW, ACSW, DCS
• Mari Teresa Cullen, BA, CADC
• Rebekah A Dagraedt
• Michael David Danner, D.D.S.
• Char Davis, PHDH
• Debra Mollie Davis, RN BSN
• Stacey Day

• Optometrist in Pekin, IL
• Providers in Pekin, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.

Verify at the official NPI Registry.