DR. MARCUS S DERANIAN (NPI# 1952367351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952367351 |
| Entity Type | Individual |
| Full Name | DR. MARCUS S DERANIAN |
| Credential | M.D. |
| Practice Address |
2442 N Route 121 Decatur IL 62526-9461 |
| Practice Telephone | 2172333101 |
| Practice Fax Number | 2172333107 |
| Mailing Telephone | 2172333101 |
| Mailing Fax Number | 2172333107 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2009-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 036069820 | IL | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
036069820 | IL | Eye and Vision Services Providers |
| Y | 207W00000X | Ophthalmology | 036-069820 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTHLINK | 374073 | 01 |
| IL | 036069820 | 05 | |
| IL | RAILROAD MEDICARE | 180033361 | 01 |
| IL | PERSONAL CARE | 49175 | 01 |
| Street Address |
2442 N ROUTE 121 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-9461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630787 | Mid-state Eye Partners Inc | Optometrist | 2442 N Route 121, Decatur, IL 62526-9461 | 2020-05-15 |
| 1093854820 | Center for Sight of Central Illinois Sc | Durable Medical Equipment & Medical Supplies | 2442 N Route 121, Decatur, IL 62526-9461 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366816696 | Laser Eye Center PC | Ophthalmology | 1238 13th Ave Se, Decatur, AL 35601-4307 | 2015-11-24 |
| 1891998357 | Midwest Eye Associates LLC | Ophthalmology | 2442 Nw Route 121, Decatur, IL 62526 | 2007-06-11 |
| 1184755258 | Frank Cooper Bell | Ophthalmology | 2600 River Oak Dr, Decatur, GA 30033-2805 | 2007-03-08 |
| 1013072990 | John C. Lee | Ophthalmology | 1714 S Blaine Ln, Decatur, IL 62521-5025 | 2006-12-22 |
| 1760592414 | Maung Maung Tin | Ophthalmology | 1770 East Lake Shore Dr, Suite 101, Decatur, IL 62521-3886 | 2006-08-30 |
| 1861425787 | Charles Smith Hill | Ophthalmology | 4171 Snapfinger Woods Dr, Decatur, GA 30035-3412 | 2006-07-07 |
| 1093707325 | Gayle Leff Goldstein | Ophthalmology | 465 Winn Way, Ste 140, Decatur, GA 30030-1753 | 2005-08-23 |
| 1164423075 | Indira Gm Menon | Ophthalmology | 1457 Scott Blvd, Decatur, GA 30030 | 2005-08-02 |
| 1932106333 | Stuart H Silverman | Ophthalmology | 5243 Snapfinger Woods Dr, Suite 101, Decatur, GA 30035-4000 | 2005-06-30 |
| 1396748786 | Charles D Woods Jr. | Ophthalmology | 1320 14th Ave Se, Decatur, AL 35601-4348 | 2005-05-31 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.