PEORIA EYE PROFESSIONALS
NPI 1053852020
Optometrist in Peoria, IL

Q: What is Central Illinois Family Eyecare LLC's NPI number?

The NPI number for Central Illinois Family Eyecare LLC is 1053852020. It was assigned to this organization in the NPPES registry on March 10, 2017. The provider is doing business as Peoria Eye Professionals.

Q: What is Central Illinois Family Eyecare LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since March 10, 2017CLIA 14D1087405 · Waiver

4203 N SHERIDAN RD, STE A1-4, PEORIA, IL 61614(309) 686-0763(309) 685-8809 Get Directions Write a Review

NPPES record last updated: January 26, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Peoria Eye Professionals NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEORIA EYE PROFESSIONALS (NPI 1053852020) is a healthcare organization registered as an optometrist in Peoria, Illinois and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through August 3, 2028 and lists Dennis M Brtva, Owner, as its authorized official.

NPPES Registry Identity

NPI1053852020

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameCENTRAL ILLINOIS FAMILY EYECARE LLC

Location Address4203 N SHERIDAN RD, STE A1-4Peoria, IL 61614-7170

Mailing Address7815 N Knoxville Ave Ste 1aPeoria, IL 61614-2022 · (309) 839-1614 · Fax (309) 839-8874

Phone(309) 686-0763

Fax(309) 685-8809

Organization SubpartNo

Authorized OfficialDennis M BrtvaOwner · (309) 686-0763

Enumeration DateMarch 10, 2017

Last NPPES UpdateJanuary 26, 2022

NPPES CertifiedJanuary 26, 2022

✔ NPI 1053852020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in IL · 046-007731

Definition

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.

4203 N SHERIDAN RD, Peoria, IL 61614

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Other Names 1

Doing Business AsPeoria Eye Professionals

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peoria Eye Professionals is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Peoria Eye Professionals, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Ashley Foster, OD

Optometry

NPI 1396399374

2109 N VETERANS PKWY
Bloomington, IL 61704

(309) 663-2211

✔ PECOS✔ Accepts Medicare38 mi

Dennis Brtva, O.D.

Optometry

NPI 1215909056

1015 S MERCER AVE
Bloomington, IL 61701

(309) 213-9200

✔ PECOS✔ Accepts Medicare39 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1087405

Peoria Eye Professionals · Peoria, IL

Active · expires Aug 3, 2028

CLIA Number14D1087405

Laboratory TypePractitioner Other

Certificate Effective DateAugust 4, 2026

Certificate Expiration DateAugust 3, 2028

Laboratory DirectorDennis M. Brtva

Laboratory Phone(309) 839-1614

Laboratory LocationPeoria Eye Professionals7815 N Knoxville Ave - St 1A, Peoria, IL 61614

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Central Illinois Family Eyecare LLC's NPI number?

The NPI number for Central Illinois Family Eyecare LLC is 1053852020. It was assigned to this organization in the NPPES registry on March 10, 2017. The provider is doing business as Peoria Eye Professionals.

Where is Central Illinois Family Eyecare LLC located?

Central Illinois Family Eyecare LLC is located at 4203 N Sheridan Rd Ste A1-4, Peoria, IL 61614. The listed phone number is (309) 686-0763.

What is Central Illinois Family Eyecare LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Central Illinois Family Eyecare LLC enrolled in Medicare?

Yes. Central Illinois Family Eyecare LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Central Illinois Family Eyecare LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Central Illinois Family Eyecare LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Central Illinois Family Eyecare LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1087405) is associated with this NPI, valid through August 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Central Illinois Family Eyecare LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Central Illinois Family Eyecare LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Central Illinois Family Eyecare LLC was last updated on January 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.