Advance Vision Eye Care, S.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036101730 Issued in IL

Legal business name

ADVANCE VISION EYE CARE, S.C.

Practice address

1770 E Lake Shore Dr
Suite 101
Decatur, IL 62521-3886

Phone

(217) 233-1405

Fax

(217) 233-1407

NPI assigned

Aug 25, 2006

Last updated

Jan 6, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Maung Maung Tin, MDNPI 1760592414

Title

Medical Doctor/ Ophthalmologist

Phone

(217) 233-1405

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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.

• Maung Maung Tin, MD

  • Ophthalmology Physician
  • Decatur, IL
  • NPI 1760592414
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1861500555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DRIVE",
            "address_2": "SUITE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213886",
            "telephone_number": "217-233-1405",
            "fax_number": "217-233-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "address_2": "SUITE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213886",
            "telephone_number": "217-233-1405",
            "fax_number": "217-233-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE VISION EYE CARE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "TIN",
        "authorized_official_first_name": "MAUNG",
        "authorized_official_middle_name": "MAUNG",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/ OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "217-233-1405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036101730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION LICENSE",
            "identifier": "042618472",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101730",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.