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DR. MATTHEW ROBERT JONES OD
NPI 1578727368
Optometrist in Effingham, IL

Active since July 11, 2008PECOS EnrolledAccepts Medicare Assignment
96.66/100
CMS Quality Rating
118 W WASHINGTON AVE, EFFINGHAM, IL 62401(217) 342-2672(217) 342-2681 Get Directions Write a Review

NPPES record last updated: July 14, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Matthew Robert Jones Od NPPES

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

DR. MATTHEW ROBERT JONES OD (NPI 1578727368) is an individual optometrist in Effingham, Illinois, licensed in Illinois (046010064) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2008).

NPPES Registry Identity

NPI1578727368
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. MATTHEW ROBERT JONESCredential: OD
Location Address118 W WASHINGTON AVEEffingham, IL 62401-2354
Mailing Address118 W Washington AveEffingham, IL 62401-2354 · (217) 342-2672 · Fax (217) 342-2681
Phone(217) 342-2672
Fax(217) 342-2681
Sole ProprietorYes
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2008
Enumeration DateJuly 11, 2008
Last NPPES UpdateJuly 14, 2008
✔ NPI 1578727368 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 · 046010064
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.
118 W WASHINGTON AVE, Effingham, IL 62401
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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. Matthew Robert Jones Od 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 ID1951474998
PECOS Enrollment IDI20080723000794
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

4

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

Drs. Sehy And Jones Optometrists, P.C.
0.8 mi
Optometrist
303 N. KELLER DRIVE
Effingham, IL 62401
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Drs Sehy And Jones Optometrists PC
  • 9 clinicians in this Medicare group
NPI 1003026204 (217) 342-2672
Mattoon Vision Associates
26 mi
Optometrist
1120 LAKE LAND BLVD STE 1
Mattoon, IL 61938
  • Reassigned Medicare billing, Illinois enrollment
  • 3 clinicians in this Medicare group
NPI 1851500524 (217) 258-8466
Christian County Visionary
34 mi
Optometrist
104 OAK ST # 5
Pana, IL 62557
  • Reassigned Medicare billing, Illinois enrollment
  • 4 clinicians in this Medicare group
NPI 1508526864 (217) 562-2512
Great Rivers Eye Care
96 mi
Optometrist
519 S STATE ST
Jerseyville, IL 62052
  • Reassigned Medicare billing, Illinois enrollment
  • 2 clinicians in this Medicare group
NPI 1770294449 (217) 342-2672

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 13

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.

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.
467 services235 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.
353 services350 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.
299 services269 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.
131 services110 patients
Microfluid analysis of tears 83861
Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.
105 services36 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
85 services83 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62401 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.

96.66/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality93.33
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
100%144 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
100%80 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%2,586 patients5/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
100%82 patients
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 578 patients
Patients totalRate: 0% · 578 patients
0%578 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 3

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

DR. MICHAEL FREDERICH SEHY OD
Optometrist
118 W WASHINGTON AVE
EFFINGHAM, IL 62401
Effingham County (217) 342-2672
DR. ROBERT WAYNE JONES OD
Optometrist
118 W WASHINGTON AVE
EFFINGHAM, IL 62401
Effingham County (217) 342-2672
DR. MICHAEL BRIAN SEHY OD
Optometrist
118 W WASHINGTON AVE
EFFINGHAM, IL 62401
Effingham County (217) 342-2367

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 Matthew Jones's NPI number?

The NPI number for Matthew Jones is 1578727368. It was assigned to this individual provider in the NPPES registry on July 11, 2008.

Where is Matthew Jones located?

Matthew Jones practices at 118 W Washington Ave, Effingham, IL 62401. The listed phone number is (217) 342-2672.

What is Matthew Jones's specialty?

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

Is Matthew Jones enrolled in Medicare?

Yes. Matthew Jones 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.

Which organizations bill Medicare for Matthew Jones's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Jones reassigns Medicare benefits to 4 organizations: Drs. Sehy And Jones Optometrists, P.C. (Effingham, IL), Mattoon Vision Associates (Mattoon, IL), Christian County Visionary (Pana, IL) and Great Rivers Eye Care (Jerseyville, IL). Each 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 Matthew Jones's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Jones accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 10 other insurers list Matthew Jones 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 Matthew Jones was last updated on July 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.