Yannis N Kolettis, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036104432 Issued in IL

Practice address

8921 N. Wood Sage Rd.
Peoria, IL 61615-7822

Phone

(309) 243-2400

Fax

(309) 243-7918

NPI assigned

Sep 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Ophthalmology

Education

University of Virginia School of Medicine, 1996

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)

Hospital & facility affiliations

• Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
• Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

Merit-based Incentive Payment System (MIPS)

Final score

90.67 of 100Reported as group

Quality

95.34

Promoting interoperability

100

Improvement activities

40

Cost

73.56

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Wyman Sicher Eye Associates SC

  • Ophthalmology Physician
  • Peoria, IL
  • NPI 1679593123

  IL, Ophthalmology

  Medicare reassignment Care Compare group NPD
• Wyman Sicher Eye Associates SC

  • Eyewear Supplier
  • Pekin, IL
  • NPI 1114537123

  Ophthalmology

  Care Compare group NPD
• Wyman Sicher Eye Associates SC

  • Eyewear Supplier
  • Washington, IL
  • NPI 1184042798
  Care Compare group
• Wyman Sicher Eye Associates SC

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1285779546
  Care Compare group

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

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755

  Hospital

  Care Compare affiliation
• Pekin Memorial Hospital

  • General Acute Care Hospital
  • Pekin, IL
  • NPI 1245227479

  Hospital

  Care Compare affiliation
• Proctor Community Hospital

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1033116876

  Hospital

  Care Compare affiliation
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1922095579",
    "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": "309-243-7918"
        },
        {
            "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": "309-243-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLETTIS",
        "first_name": "YANNIS",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036104432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104432",
            "state": "IL"
        }
    ],
    "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": []
}

• Marysue Patricia Koelling
• Michael Koeppen, MD
• Truc-Quynh D Kohlmeyer
• Stephanie Kok, M.D.
• Jennifer Lee Kolettis, NP-C
• Venkat Yashaswi Kondapalli
• Derek Koon
• Kathleen Koors
• Christopher Kopan
• Gretchen L Kopec, M.D.

• All providers in Peoria, IL
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.