Southwestern Eye Care
Organization Active NPI Optometrist · Brighton, IL
NPI 1801008982 · NPPES record last updated Aug 17, 2012
Key facts
- NPI
- 1801008982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- SOUTHWESTERN EYE CARE
- Practice address
- 101 N Maple St
Brighton, IL 62012-1053 - Phone
- (618) 372-7000
- Fax
- (618) 372-7003
- NPI assigned
- May 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Kathy R Foiles
- Title
- Accounts Receivable
- Phone
- (618) 372-7000
Practitioners 3
-
Marcus Andrew Cuff, O.D
-
Dirk F Massie, OD
-
Lauren Dust, OD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2092073 | Southwestern Eye Care LTD | Certificate of waiver | Feb 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930010392 | IL | DME Supplier - Physician - Optometrist | 9436164654 | Practice locations: Brighton, IL |
National Provider Directory
Locations
101 N Maple St
Brighton, IL 62012
Phone (618) 372-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | IL | Yes |
Addresses
Primary practice location
101 N Maple St
Brighton, IL 62012-1053
Mailing address
101 N Maple St
Brighton, IL 62012-1053
Phone (618) 372-7000
Other providers in Brighton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.