NPIMap

Organization Active NPI

Marion Eye Centers LTD.

  • Durable Medical Equipment & Medical Supplies
  • Herrin, IL
National Provider Identifier
1902961576
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
036051996 Issued in IL
Legal business name
MARION EYE CENTERS LTD.
Practice address
321 S Park Ave
Herrin, IL 62948-3603
Phone
(618) 942-2900
Fax
(618) 942-4199
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Authorized official

Name
Maqbool Ahmad, M.D.
Title
President Owner
Phone
(618) 993-5686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 036051996 IL Primary

Addresses

Primary practice location

321 S Park Ave
Herrin, IL 62948-3603

Mailing address

1200 W Deyoung St
P.O. Box 1178
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers 2

IdentifierTypeStateIssuer
036051996MedicaidIL
203169800MedicaidMO

Other names 1

  • Marion Eye Centers, Ltd. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930052629 IL DME Supplier - Physician - OptometristDME Supplier - Physician - Ophthalmology 3072426774 Practice locations: Herrin, IL

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
Marion Eye Centers LTD321 S Park Ave, Herrin, IL 62948-3603(618) 942-2900 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Marion Eye Centers Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

321 S Park Ave
Herrin, IL 62948
Phone (618) 942-2900

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502064000000",
    "number": "1902961576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "address_2": "P.O. BOX 1178",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483603",
            "telephone_number": "618-942-2900",
            "fax_number": "618-942-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION EYE CENTERS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2017-08-07",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MAQBOOL",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "618-993-5686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036051996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051996",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203169800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Eye Centers, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.