Individual provider Active NPI

Maxx M Craggs, OD

  • Optometrist
  • Taylorville, IL
National Provider Identifier
1942680228
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010871 Issued in IL
Practice address
900 W Springfield Rd
Taylorville, IL 62568-1299
Phone
(217) 824-4991
Fax
(217) 824-5414
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010871 IL Primary

Addresses

Primary practice location

900 W Springfield Rd
Taylorville, IL 62568-1299

Mailing address

900 W Springfield Rd
Taylorville, IL 62568-1299
Phone (217) 824-4991

Other identifiers 1

IdentifierTypeStateIssuer
046010871MedicaidIL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150619001489 IL Practitioner - Optometry 3577874353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Optometric Associates LTDGroup PAC ID 7618886318, 4 clinicians

Practice addresses (Care Compare)

900 W Springfield Rd
Suite 2
Taylorville, IL 62568-1299
Phone (217) 824-4991

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010871ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Optometric Associates LTD Optometrist CurrentSince Jun 15, 2015 Accepting new patients
Central Illinois Optometric Associates LTD Optometrist CurrentSince Jun 15, 2015 Accepting new patients

Locations

623 Pulaski St
Lincoln, IL 62656
Phone (217) 732-9606

900 W Springfield Rd
Ste 2
Taylorville, IL 62568
Phone (217) 287-1300

900 W Springfield Rd
Taylorville, IL 62568
Phone (217) 824-4400

119 N Springfield St
Virden, IL 62690
Phone (217) 965-3306

Interoperability endpoints

  • Direct secure messaging: maxx.craggs@adveyecare.eyefinity-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1942680228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W SPRINGFIELD RD",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681299",
            "telephone_number": "217-824-4991",
            "fax_number": "217-824-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W SPRINGFIELD RD",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681299",
            "telephone_number": "217-824-4991",
            "fax_number": "217-824-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAGGS",
        "first_name": "MAXX",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010871",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorville, IL

Sources for this page

Verify at the official NPI Registry.