John Robert Eigenbrodt, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008144 Issued in IL

Practice address

1950 Edwardsville Club Plaza
Edwardsville, IL 62025-3517

Phone

(618) 656-3199

Fax

(618) 656-3099

NPI assigned

Jul 13, 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 9

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411
  Medicare reassignment Care Compare group NPD
• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1033261904
  NPD (past)
• Naumann Optics Inc

  • Eyewear Supplier
  • Columbia, IL
  • NPI 1578740031

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1982602918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 EDWARDSVILLE CLUB PLAZA",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253517",
            "telephone_number": "618-656-3199",
            "fax_number": "618-656-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 EDWARDSVILLE CLUB PLAZA",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253517",
            "telephone_number": "618-656-3199",
            "fax_number": "618-656-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIGENBRODT",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5932266",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "06032220",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "203722190",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN",
            "identifier": "203722190",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "274260",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IL8144",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "125215",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCB SHIELD MO",
            "identifier": "125419",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN RAIL RD MEDICARE",
            "identifier": "POO429582",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwardsville NH LLC
• Edwardsville Nursing and Rehab Center LLC
• Edwardsville Physicians Group LLC
• Rebecca Eggering
• Eigenbrodt Vision Center, P.C.
• Meagan Eilers
• Elfatih Eisa
• Morgan Nicole Ekstrom, OTD, OTR/L
• Brianna Susan Ellis
• Gabrielle A Ellis, RBT

• Optometrist in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.
• 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.