PRAIRIE EYE CENTER, LTD – Optometrist, NPI 1366035644
Optometrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PRAIRIE EYE CENTER, LTD
2020 W ILES AVE
SPRINGFIELD, IL 627044174
Phone: (217) 698-3030
Fax: (217) 698-3068
Type: Mailing
518 BROADWAY ST
LINCOLN, IL 626562706
Phone: (217) 732-6062
Fax: (217) 732-8495
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.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (70 days ago).
Enrollment records
1
Earliest due date
2026-03-31
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 |
|---|---|---|---|---|
| O20031111000811 | O | Clinic/Group Practice | IL | 2026-03-31 |
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 62704)
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