Individual provider Active NPI

Min-Kyu Han, M.D.

  • Ophthalmology Physician
  • Peoria, IL
National Provider Identifier
1912901877
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036127783 Issued in IL
Practice address
8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone
(309) 243-2400
Fax
(309) 243-5692
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036127783 IL Primary

Addresses

Primary practice location

8921 N Wood Sage Rd
Peoria, IL 61615-7822

Mailing address

8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-2400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000753 IL Practitioner - Ophthalmology 5890765341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wake Forest University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyman Sicher Eye Associates SCGroup PAC ID 7911965801, 20 clinicians

Practice addresses (Care Compare)

8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-2400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.12 of 100Reported as individual
Quality
92.58
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0058740MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyman Sicher Eye Associates SC Ophthalmology CurrentSince Sep 1, 2011 Accepting new patients
Wyman Sicher Eye Associates SC Ophthalmology CurrentSince Sep 1, 2011 Accepting new patients
Bert M. Glaser National Retina Institute, LLC Ophthalmology Past Accepting new patients
Katzen Medical Associates, PC Ophthalmology Past Accepting new patients

Locations

2709 Broadway St
Pekin, IL 61554
Phone (309) 243-2400

8921 N Wood Sage Rd
Peoria, IL 61615
Phone (309) 243-2400

Interoperability endpoints

  • Direct secure messaging: direct@illinoiseyecenterpeoriail.compulinkdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1912901877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "MIN-KYU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036127783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com",
            "affiliation": "N",
            "endpointDescription": "CCD only, does not accept attachments",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8921 N Wood Sage Rd",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616157822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.