VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD.
NPI 1073756490
Optometrist in Morton, IL
NPI Status: Active since April 15, 2009
Contact Information
417 W JEFFERSON ST
MORTON, IL
ZIP 61550
Phone: (309) 263-8611
Fax: (309) 263-8926
- Organization
- Optometrist
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 14D2096392
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-21-2027
About VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD.
This page provides the complete NPI Profile along with additional information for Vintage Optical Brian C Sommer, Od, Ltd., a provider established in Morton, Illinois operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1073756490 assigned on April 2009. The practitioner's primary taxonomy code is 152W00000X with license number 046.007309 (IL). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Susan E Colby (Corp Secretary)
- NPI
- 1073756490
- Provider Name
- VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD.
- Entity Type
- Organization
- Location Address
- 417 W JEFFERSON ST MORTON, IL 61550
- Location Phone
- (309) 263-8611
- Location Fax
- (309) 263-8926
- Mailing Address
- 417 W JEFFERSON ST. MORTON, IL 61550
- Mailing Phone
- (309) 263-8611
- Mailing Fax
- (309) 263-8926
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-15-2009
- Last Update Date
- 02-13-2013
- Code Navigator
Vintage Optical Brian C Sommer, Od, Ltd. is a medicare supplier with PTAN 20582423 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Heat & Cold Applications or Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses or Surgical Dressings.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 046.007309
- License State
- IL
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- BlueCross B07S HSA - EPO
- BlueCross B15S $0 virtual care from Teladoc Health � - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- WellFirst by Medica Bronze $0 Copay PCP Visits - EPO
- WellFirst by Medica Bronze Share - EPO
- WellFirst by Medica Catastrophic - EPO
- WellFirst by Medica Expanded Bronze Standard - EPO
- WellFirst by Medica Gold $0 Copay PCP Visits - EPO
- WellFirst by Medica Gold Copay Plus - EPO
- WellFirst by Medica Gold Standard - EPO
- WellFirst by Medica Silver $0 Copay PCP Visits - EPO
- WellFirst by Medica Silver Copay Plus - EPO
- WellFirst by Medica Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 410046605 | OTHER (01) | MEDICARE RAILROAD | |
| IL6829 | MEDICARE UPIN (02) | IL | |
| 4429890001 | MEDICARE NSC (07) | ||
| 10760649 | OTHER (01) | CAQH PROVIDER ID |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20582423
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist, Optician.
- Competitive Bidding
- NO
Supplies List
- Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D2096392
- Facility Type
- Physician Office
- Certificate Effective Date
- May 22, 2025
- Certificate Expiration Date
- May 21, 2027
- Laboratory Director
- BRIAN C. SOMMER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Vintage Optical Brian C Sommer, Od, Ltd. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 7 | 3 | 7 | 5 | 6 | 4 | 9 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 14 | 3 | 14 | 5 | 12 | 4 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 4 + 3 + 1 + 4 + 5 + 1 + 2 + 4 + 1 + 8 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1073756490 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1003986522 | DR. BRIAN C SOMMER O.D. Individual | Optometrist | 417 W JEFFERSON ST MORTON, IL 61550 (309) 263-8611 |
| 1093128886 | PAUL O VELTING O.D. Individual | Optometrist (Corneal and Contact Management) | 417 W JEFFERSON ST MORTON, IL 61550 (309) 263-8611 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073756490, enumerated in the NPI registry as an "organization" on April 15, 2009
The provider is located at 417 W Jefferson St Morton, Il 61550 and the phone number is (309) 263-8611
This medical organization specializes in Optometrist with taxonomy code 152W00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, BlueCross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 14D2096392 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on April 15, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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