NPIMap

Organization Active NPI

Family Eye Care Association, P.C.

  • Optometrist
  • Hillsboro, IL
National Provider Identifier
1821029836
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007103 Issued in IL
Legal business name
FAMILY EYE CARE ASSOCIATION, P.C.
Practice address
675 School St
Hillsboro, IL 62049-1530
Phone
(217) 532-5044
Fax
(217) 532-2109
NPI assigned
Jul 6, 2006
Last updated
Mar 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Douglas W. Johnson, O.D.NPI 1356304794
Title
President
Phone
(217) 532-5044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 046007103 IL Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 046008320 IL

Addresses

Primary practice location

675 School St
Hillsboro, IL 62049-1530

Mailing address

675 School St
Hillsboro, IL 62049-1530
Phone (217) 532-5044

Other identifiers 3

IdentifierTypeStateIssuer
046008093MedicaidIL
046007103MedicaidIL
046008320MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061205000419 IL Part B Supplier - Clinic/Group Practice 1951300771 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
Practice locations: Greenville, IL; Hillsboro, IL; Litchfield, IL
O20100930052205 IL DME Supplier - Physician - Optometrist 1951300771 Practice locations: Hillsboro, IL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Family Eye Care Association PC675 School St, Hillsboro, IL 62049-1530(217) 532-5044 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Family Eye Care Assoc P3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1821029836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 SCHOOL ST",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620491530",
            "telephone_number": "217-532-5044",
            "fax_number": "217-532-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SCHOOL ST",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620491530",
            "telephone_number": "217-532-5044",
            "fax_number": "217-532-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE ASSOCIATION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-532-5044",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007103",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008320",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008093",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007103",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008320",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.