Individual provider Active NPI

Eric D Coy, O.D.

  • Optometrist
  • Rockford, IL
National Provider Identifier
1851656847
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010571 Issued in IL
Practice address
7200 Harrison Ave
Rockford, IL 61112-1033
Phone
(815) 332-5733
Fax
(815) 332-4196
NPI assigned
Jul 6, 2012
Last updated
Jul 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010571 IL Primary

Addresses

Primary practice location

7200 Harrison Ave
Rockford, IL 61112-1033

Mailing address

22519 S Country Lane
New Lenox, IL 60451-3697
Phone (815) 546-0107

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
I20140923002021 IL Practitioner - Optometry 8729207733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Northwest Eyecare PCGroup PAC ID 7012968209, 5 clinicians

Practice addresses (Care Compare)

1000 Kiwanis Dr
Freeport, IL 61032-6921
Phone (815) 235-6177

1000 S Kiwanis Dr
Freeport, IL 61032-6921

116 N Broad St
Lanark, IL 61046-1004
Phone (815) 493-2700

312 E N Ave
Stockton, IL 61085-1206
Phone (815) 947-2424

314 W Washington St
Oregon, IL 61061-1622
Phone (815) 732-3121

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as individual
Quality
77.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010571ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Eyecare PC Optometrist CurrentSince Jan 1, 2017 Accepting new patients
Jason Lam O.D., M.B.a., Inc. Optometrist Past Accepting new patients

Locations

1000 Kiwanis Dr
Freeport, IL 61032
Phone (815) 233-3277

116 N Broad St
Lanark, IL 61046
Phone (815) 235-6177

314 W Washington St
Oregon, IL 61061
Phone (815) 235-6177

312 E North Ave
Stockton, IL 61085
Phone (815) 947-2424

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1851656847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22519 S COUNTRY LANE",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513697",
            "telephone_number": "815-546-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 HARRISON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611121033",
            "telephone_number": "815-332-5733",
            "fax_number": "815-332-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COY",
        "first_name": "ERIC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.