NPIMap

Organization Active NPI

Marion Eye Centers LTD

  • Durable Medical Equipment & Medical Supplies
  • Mount Vernon, IL
National Provider Identifier
1992860548
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
036051996 Issued in IL
Legal business name
MARION EYE CENTERS LTD
Practice address
2900 Broadway St
Ste. a
Mount Vernon, IL 62864-2341
Phone
(618) 244-7777
Fax
(618) 899-9022
NPI assigned
Dec 26, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Maqbool Ahmad, M.D.
Title
President Owner
Phone
(618) 993-5686

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2078582Marion Eye Centers LTD2900 Broadway, Ste a, Mount Vernon, IL 62864Certificate of waiverMay 29, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Marion Eye Centers LTD2900 Broadway St, Mount Vernon, IL 62864-2341(618) 244-2777 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930052627 IL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 3072426774 Practice locations: Mount Vernon, IL

National Provider Directory

National Provider Directory
Tax ID family
Marion Eye Centers Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

2900 Broadway St
#A
Mount Vernon, IL 62864
Phone (618) 244-2777

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 036051996 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

2900 Broadway St
Ste. a
Mount Vernon, IL 62864-2341

Mailing address

1200 W Deyoung St
P.O. Box 1178
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
203169800MedicaidMO
036051996MedicaidIL

Other names 1

NPPES NPI Registry
  • Marion Eye Centers, Ltd. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992860548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "address_2": "P.O. BOX 1178",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BROADWAY ST",
            "address_2": "STE. A",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642341",
            "telephone_number": "618-244-7777",
            "fax_number": "618-899-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION EYE CENTERS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MAQBOOL",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "618-993-5686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036051996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203169800",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051996",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Eye Centers, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.