Mark Vidas, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

046007828 Issued in IL

Practice address

135 W River St
Bourbonnais, IL 60914-1964

Phone

(815) 939-2222

Fax

(815) 939-0970

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meyer Optical Co. Inc.Group PAC ID 0840399689, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Meyer Optical Co. Inc.

  • Optometrist
  • Bourbonnais, IL
  • NPI 1285751552
  Medicare reassignment Care Compare group NPD Authorized official
• Eligijus P Lelis MD & Associates, SC

  • Durable Medical Equipment & Medical Supplies
  • Joliet, IL
  • NPI 1780710780
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881787901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TERRACE CT",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609140806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W RIVER ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141964",
            "telephone_number": "815-939-2222",
            "fax_number": "815-939-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAS",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046007828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian David Vaughn
• Polly Marie Vaughn
• Victor Manuel Vazquez Cervantes, PHARMD
• Rebecca Ellen Veasey, PA-C
• Cole Jonathan Verbrugge, DC
• Edwin Viglia III, LPC
• Joel P Villegas, MD
• Vishwam, Inc
• Vishwam, Inc
• Vitality Family Medical & Wellness PLLC

• Corneal and Contact Management Optometrist in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Corneal and Contact Management Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.