Marcus S Deranian, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036-069820 Issued in IL

Practice address

2442 N Route 121
Decatur, IL 62526-9461

Phone

(217) 233-3101

Fax

(217) 233-3107

NPI assigned

Apr 25, 2006

Last updated

Nov 20, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Sight of Central Illinois SC

  dba Central Illinois Vision Center

  • Ophthalmology Physician
  • Decatur, IL
  • NPI 1093854820
  Authorized official Same address or phone

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1952367351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 N ROUTE 121",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269461",
            "telephone_number": "217-233-3101",
            "fax_number": "217-233-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 N ROUTE 121",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269461",
            "telephone_number": "217-233-3101",
            "fax_number": "217-233-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERANIAN",
        "first_name": "MARCUS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "036069820",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "036069820",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-069820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "374073",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180033361",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069820",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE",
            "identifier": "49175",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mary Anne Depaz, MD
• Yashvi Falguni Desai
• Allen Bernard Devleschoward Jr., M.D.
• Devoted Caregivers
• Nakeya Khozema Dewaswala, MD
• Harvinder Dhillon, MD

• Ophthalmology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.