RETINA VITREOUS ASSOCIATES, PC – Specialist, NPI 1194711655
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RETINA VITREOUS ASSOCIATES, PC
4930, West 95th Street, Oak Lawn, Worth Township, Cook County, Illinois, 60453, United States
OAK LAWN, IL 604532504
Phone: (708) 424-8855
Fax: (708) 424-6954
Type: Mailing
15255 S 94th Ave Ste 202E
Orland Park, IL 604623810
Phone: (708) 364-1700
Fax: (708) 364-1717
Type: Location
963 N 129th Infantry Dr Ste 130
Joliet, IL 604353103
Phone: (815) 744-1812
Fax: (815) 744-1589
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2009-04-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (830 days ago).
Enrollment records
1
Earliest due date
2024-02-29
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20090415000216 | O | Clinic/Group Practice | IL | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60453)
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