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DR. MARISA LEE MILLIGAN
NPI 1508240763
Dentist in Bloomington, IL

Active since July 16, 2015Opted out of Medicare · through Nov 19, 2027
1404 EASTLAND DR STE 101, BLOOMINGTON, IL 61701(309) 663-4711(309) 663-1854 Get Directions Write a Review

NPPES record last updated: July 16, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Marisa Lee Milligan NPPES

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

DR. MARISA LEE MILLIGAN (NPI 1508240763) is an individual dentist in Bloomington, Illinois, licensed in Illinois (019030295) and active in the NPI registry since July 2015. She has opted out of Medicare through November 19, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1508240763
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. MARISA LEE MILLIGAN
Location Address1404 EASTLAND DR STE 101Bloomington, IL 61701-7904
Mailing Address1404 Eastland Dr Ste 101Bloomington, IL 61701-7904 · (309) 663-4711 · Fax (309) 663-1854
Phone(309) 663-4711
Fax(309) 663-1854
Sole ProprietorNo
Enumeration DateJuly 16, 2015
✔ NPI 1508240763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019030295
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1404 EASTLAND DR STE 101, Bloomington, IL 61701
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Marisa Lee Milligan has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 19, 2015 through November 19, 2027.

Opt-Out Effective DateNovember 19, 2015
Opt-Out In Effect ThroughNovember 19, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61701 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
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.

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 Marisa Milligan's NPI number?

The NPI number for Marisa Milligan is 1508240763. It was assigned to this individual provider in the NPPES registry on July 16, 2015.

Where is Marisa Milligan located?

Marisa Milligan practices at 1404 Eastland Dr Ste 101, Bloomington, IL 61701. The listed phone number is (309) 663-4711.

What is Marisa Milligan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Marisa Milligan enrolled in Medicare?

No. Marisa Milligan has opted out of Medicare through November 19, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Marisa Milligan was last updated on July 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.