Tanya Chugh Qualls, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011429 Issued in IL

Practice address

525 W Town Center Blvd
Champaign, IL 61822-1248

Phone

(217) 531-5393

NPI assigned

Jun 4, 2020

Sex

Female

Sole proprietor

No

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vep Il Optometric LLCGroup PAC ID 3678814217, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Vep Il Optometric LLC

  • Optometrist
  • Bloomington, IL
  • NPI 1528536620
  Medicare reassignment Care Compare group
• Oneopto Il 2 PLLC

  • Optometrist
  • Bloomington, IL
  • NPI 1003788431
  NPD (past)

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1902420011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W TOWN CENTER BLVD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221248",
            "telephone_number": "217-531-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W TOWN CENTER BLVD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221248",
            "telephone_number": "217-531-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "TANYA",
        "middle_name": "CHUGH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phelicia Puryear
• Madeline Puto
• Puzzle Business Group LLC
• Chasity Lynn Pyle
• Mohammed Usman Qasim, MD
• Quednau Hearing. Inc
• Theresa Quednau
• Ann Marlyn Quiban
• Erika Quinn, MSW
• Alex Balmore Quintanilla, LCSW 84870

• Optometrist in Champaign, IL
• Providers in Champaign, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.