DR. ENRIQUE PERALTA
NPI 1346237534
Ophthalmology in Swansea, IL

Q: What is Enrique Peralta's NPI number?

The NPI number for Enrique Peralta is 1346237534. It was assigned to this individual provider in the NPPES registry on October 3, 2005.

Q: What is Enrique Peralta's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Enrique Peralta was last updated on April 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.

Active since October 03, 2005PECOS EnrolledAccepts Medicare Assignment

80.42/100

CMS Quality Rating

3990 N ILLINOIS ST, SWANSEA, IL 62226(618) 277-1130(618) 277-4917 Get Directions Write a Review

NPPES record last updated: April 16, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Enrique Peralta NPPES

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

DR. ENRIQUE PERALTA (NPI 1346237534) is an individual ophthalmology provider in Swansea, Illinois, licensed in Illinois (036-112111) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, maintains 8 additional practice locations, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1346237534

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. ENRIQUE PERALTA

Location Address3990 N ILLINOIS STSwansea, IL 62226-1919

Mailing Address3990 N Illinois StSwansea, IL 62226-1919 · (618) 277-1130 · Fax (618) 277-4917

Phone(618) 277-1130

Fax(618) 277-4917

Sole ProprietorNo

Medical School CMSOtherGraduated 1986

Enumeration DateOctober 3, 2005

Last NPPES UpdateApril 16, 2026

NPPES CertifiedApril 16, 2026

✔ NPI 1346237534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Licenses✔ Licensed in IL · 036-112111✔ Licensed in MO · 2004012770

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.

3990 N ILLINOIS ST, Swansea, IL 62226

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Secondary Practice Locations 8

Location 1408 W 2nd StCentralia, IL 62801-3402 · Phone (618) 532-5531

Location 24900 W Main StBelleville, IL 62226-4725 · Phone (618) 235-2400 · Fax (618) 277-4917

Location 312 Professional Park DrMaryville, IL 62062-5672 · Phone (618) 288-7266 · Fax (618) 277-4917

Location 41310 Dadrian Prof ParkGodfrey, IL 62035-1685 · Phone (618) 433-5005 · Fax (618) 277-4917

Location 52421 Corporate CtrGranite City, IL 62040-4148 · Phone (618) 931-6980 · Fax (618) 277-4917

Location 61066 Executive Parkway Dr Ste 200Saint Louis, MO 63141-6340 · Phone (314) 394-3201 · Fax (314) 394-3253

Location 73000 Broadway StMount Vernon, IL 62864-2340 · Phone (618) 242-4141 · Fax (618) 277-4917

Location 82121 S State Route 157Edwardsville, IL 62025-3607 · Phone (618) 277-1130 · Fax (618) 277-4917

Other Identifiers 2

Medicaid209310200MO

Medicaid036112111IL

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Enrique Peralta 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 ID6709849102

PECOS Enrollment IDI20041108000009, I20041214000872

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.

Medicare Billing Reassignments

Medicare enrollment records show Enrique Peralta reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Jfj Eyecare, Ltd

Same address

Optometrist

3990 N ILLINOIS ST
Swansea, IL 62226

Reassigned Medicare billing, Illinois and Missouri enrollments
32 clinicians in this Medicare group

NPI 1376586685 (636) 200-4393

Retina Center PC

26 mi

Ophthalmology

11710 OLD BALLAS RD, SUITE 102
Saint Louis, MO 63141

Reassigned Medicare billing, Missouri enrollment
4 clinicians in this Medicare group

NPI 1861539694 (314) 569-2020

Ophthalmology Consultants, LLC

26 mi

Ophthalmology

12990 MANCHESTER RD, SUITE 200
Saint Louis, MO 63131

Reassigned Medicare billing, Missouri enrollment
25 clinicians in this Medicare group

NPI 1003960980 (314) 966-5000

Bond Eye Associates, Sc

139 mi

Ophthalmology

725 S 14TH ST
Pekin, IL 61554

Reassigned Medicare billing, Illinois enrollment
8 clinicians in this Medicare group

NPI 1285725903 (309) 353-6660

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

Areas of Expertise CMS Part B claims 19

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.

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

9,840 services31 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

1,156 services385 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

791 services202 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

439 services130 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.

361 services258 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

352 services43 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

265 services186 patients

Extended exam of the back part of the eye with optic nerve drawing 92202

This procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.

148 services125 patients

Injection, dexamethasone, intravitreal implant, 0.1 mg J7312

This procedure involves placing a tiny implant into your eye. This implant slowly releases a medication called dexamethasone, which helps to reduce inflammation and swelling in the eye, improving vision and comfort.

147 services18 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

109 services99 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

69 services53 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

60 services51 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

46 services45 patients

Injection of drug or substance into membrane covering eyeball 67515

This procedure involves injecting medication into the membrane covering your eyeball, known as the conjunctiva. It's done to treat various eye conditions. A specialist will numb your eye first to minimize discomfort. You may experience temporary blurred vision afterwards.

36 services34 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

36 services36 patients

Destruction of leaking blood vessels of retina using laser 67228

This procedure involves using a laser to treat leaking blood vessels in the retina, the part of the eye responsible for vision. The laser seals off these vessels, preventing further leakage and helping to preserve sight.

18 services12 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

14 services14 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62226 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

$131.14 typical visit price

range $56.28 – $173.35

Typical copayment $32.78 (range $14.07 – $43.33)

Most-billed visit code 99204

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

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.

80.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

34.74

Other Providers at the Same Location NPPES 12

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

DR. HOMER ASHTON FERGUSON JR. M.D.

Ophthalmology