DEREK HENNIG (OD) – Optometrist, NPI 1215466008

DEREK HENNIG (OD) is a healthcare provider. based in Charleston, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046011094 (IL). The NPI Number for DEREK HENNIG (OD) is 1215466008

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DEREK HENNIG (OD)
NPI
1215466008
Phone
(217) 345-6600
Address
1700 18TH ST
Enumeration Date
6 June 2017
Last Update Date
6 June 2017

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
2173456600
Graduation Year
2017 (9 years ago)
PAC ID
3072882331
Group Practice PAC ID
0244634541
Professional Enrollment ID
I20170630000848
Address ID
IL619203607CH1700XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for DEREK HENNIG (OD)

  • 1700, 18th Street, Charleston, Coles County, Illinois, 61920, United States

    CHARLESTON, IL 619203607

    Phone: (217) 345-6600

    Fax: (217) 345-6622

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $546.

Total Amount is formed as General ($546) + Research ($0) + Ownership ($0) = $546.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Alcon Vision LLC ($161).

Total Amount

$546

General + Research + Ownership

Payments

17

Total payment records

General Amount

$546

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-06-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170630000848IOptometryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens5,49136$0
92250Photography of the retina250243$0
92014Established patient complete exam of visual system235233$0
99213Established patient office or other outpatient visit, 20-29 minutes185145$0
92134Imaging of retina9679$0
View full utilization report →

Insurance plans in this area (ZIP 61920)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244634541View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

What is the standard ID for DEREK HENNIG (OD) in the U.S.?
In the U.S., DEREK HENNIG (OD) is identified by NPI 1215466008.
Does the public listing show DEREK HENNIG (OD) as active?
DEREK HENNIG (OD)'s NPI record reflects an active status in NPPES.
Which specialty label fits DEREK HENNIG (OD)?
NPPES ties DEREK HENNIG (OD) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DEREK HENNIG (OD)?
DEREK HENNIG (OD) shows a connection to Charleston, Illinois in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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