DR. RANDAL J. PETERSON M.D.
NPI 1184724866
Ophthalmology in Springfield, IL

Active since September 23, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1025 S 6TH ST, SPRINGFIELD, IL 62703(217) 528-7541 Get Directions Write a Review

NPPES record last updated: September 21, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 21, 2020, May 21, 2020, Oct 17, 2016 (3 updates tracked since 2016).

About Dr. Randal J. Peterson M.d. NPPES

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

DR. RANDAL J. PETERSON M.D. (NPI 1184724866) is an individual ophthalmology provider in Springfield, Illinois, licensed in Illinois (036-080194) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Southern Illinois University School Of Medicine (1986).

NPPES Registry Identity

NPI1184724866
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. RANDAL J. PETERSONCredential: M.D.
Location Address1025 S 6TH STSpringfield, IL 62703-2403
Mailing Address1200 Centre West DrSpringfield, IL 62704-2173 · (217) 528-7541 · Fax (217) 528-8962
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 1986
Enumeration DateSeptember 23, 2006
Last NPPES UpdateSeptember 21, 20203 updates tracked since enumeration
NPPES CertifiedSeptember 21, 2020
NPI 1184724866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in IL · 036-080194
Definition
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.
1025 S 6TH ST, Springfield, IL 62703

Other Identifiers 1

Medicaid036080194IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Randal J. Peterson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597785014
PECOS Enrollment IDI20060112000794
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
464 services15 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
429 services405 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
358 services245 patients
Ultrasound scan to determine eye length and lens power 76519
An ultrasound scan for the eye is a safe, non-invasive procedure. It uses sound waves to create images of your eye's structure. This helps determine the length of your eye and the power of your lens, which is crucial for diagnosing eye conditions and planning surgeries.
274 services198 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
273 services176 patients
Ultrasound scan to determine eye length and lens power 76519
An ultrasound scan for the eye is a safe, non-invasive procedure. It uses sound waves to create images of your eye's structure. This helps determine the length of your eye and the power of your lens, which is crucial for diagnosing eye conditions and planning surgeries.
196 services196 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62703 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
75%256 patients4/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
98%256 patients4/55-star benchmark: 100%
Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance…
99%172 patients
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
12%51 patients1/55-star benchmark: 95%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%55 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
89%64 patients4/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
85%71 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%4,251 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%1,145 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%514 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
99%1,697 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 98% · 684 patients
Patients tobacco: 90% · 684 patients
3%58 patients1/55-star benchmark: 98%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
97%222 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
81%1,697 patients4/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 1,326 patients
0%1,326 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1025 S 6TH ST
SPRINGFIELD, IL 62703
Counselor
1025 S 6TH ST
SPRINGFIELD, IL 62703
Anesthesiology
1025 S 6TH ST
SPRINGFIELD, IL 62703
Nurse Practitioner (Family)
1025 S 6TH ST
SPRINGFIELD, IL 62703
Nurse Anesthetist, Certified Registered
1025 S 6TH ST
SPRINGFIELD, IL 62703
Internal Medicine
1025 S 6TH ST
SPRINGFIELD, IL 62703
Internal Medicine
1025 S 6TH ST
SPRINGFIELD, IL 62703
Ophthalmology
1025 S 6TH ST
SPRINGFIELD, IL 62703

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 Randal Peterson's NPI number?

The NPI number for Randal Peterson is 1184724866. It was assigned to this individual provider in the NPPES registry on September 23, 2006.

Where is Randal Peterson located?

Randal Peterson practices at 1025 S 6th St, Springfield, IL 62703. The listed phone number is (217) 528-7541.

What is Randal Peterson's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Randal Peterson enrolled in Medicare?

Yes. Randal Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Randal Peterson affiliated with any hospitals?

According to CMS data, Randal Peterson is affiliated with St Johns Hospital.

When was this NPI record last updated?

The NPPES record for Randal Peterson was last updated on September 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.