Individual provider Active NPI

Austin C Krohn, O.D.

  • Optometrist
  • Quincy, IL
National Provider Identifier
1962678268
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010052 Issued in IL
Practice address
3325 Maine St
Quincy, IL 62301-4457
Phone
(217) 231-3937
Fax
(217) 231-3940
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2007030965 MO
Optometrist 152W00000X 046010052 IL Primary

Addresses

Primary practice location

3325 Maine St
Quincy, IL 62301-4457

Mailing address

3325 Maine St
Quincy, IL 62301-4457
Phone (217) 231-3937

Other identifiers 2

IdentifierTypeStateIssuer
318758604MedicaidMO
046010052MedicaidIL

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
I20080726000132 IL Practitioner - Optometry 4385717131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eyecare and Contact LensGroup PAC ID 2769510353, 2 clinicians

Practice addresses (Care Compare)

3325 Maine St
Suite 1
Quincy, IL 62301-4470
Phone (217) 231-3937

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 surgery47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010052ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare and Contact Lens Optometrist CurrentSince Jan 23, 2023 Accepting new patients
Family Eyecare and Contact Lens Optometrist CurrentSince Jan 23, 2023 Accepting new patients

Locations

3325 Maine St
Ste 1
Quincy, IL 62301
Phone (217) 231-3937

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1962678268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014457",
            "telephone_number": "217-231-3937",
            "fax_number": "217-231-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014457",
            "telephone_number": "217-231-3937",
            "fax_number": "217-231-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROHN",
        "first_name": "AUSTIN",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2007030965",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318758604",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010052",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.