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DR. JONATHAN EDWARD MICETICH O.D.
NPI 1740273754
Optometrist in Coal City, IL

Active since August 24, 2005PECOS EnrolledAccepts Medicare Assignment
20 E NORTH STREET, COAL CITY, IL 60416(815) 634-4825(815) 634-4938 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Jonathan Edward Micetich O.d. NPPES

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

DR. JONATHAN EDWARD MICETICH O.D. (NPI 1740273754) is an individual optometrist in Coal City, Illinois, licensed in Illinois (046008925) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1996).

NPPES Registry Identity

NPI1740273754
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JONATHAN EDWARD MICETICHCredential: O.D.
Location Address20 E NORTH STREETCoal City, IL 60416-1087
Mailing Address1950 Old Gallows Rd Ste 520Vienna, VA 22182-3970 · (703) 847-8899 · Fax (571) 223-6780
Phone(815) 634-4825
Fax(815) 634-4938
Sole ProprietorYes
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1996
Enumeration DateAugust 24, 2005
Last NPPES UpdateMarch 25, 2021
NPPES CertifiedMarch 25, 2021
✔ NPI 1740273754 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 · 046008925
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.
20 E NORTH STREET, Coal City, IL 60416
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Other Identifiers 3

Medicaid046008925IL
Other3232003IL · Blue Cross Blue Shield Of Illinois
Other5075840001IL · National Goverment Services

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware 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. Jonathan Edward Micetich O.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 ID1456569193
PECOS Enrollment IDI20110222000116
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 Reassignment

Medicare enrollment records show Jonathan Micetich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Myeyedr Optometry Of Illinois, LLC
Same address
Optometrist
20 E NORTH ST
Coal City, IL 60416
  • Reassigned Medicare billing, Illinois enrollment
  • 114 clinicians in this Medicare group
NPI 1972180149 (815) 634-4825

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 7

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.
3,014 services22 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.
84 services84 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.
34 services25 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.
28 services19 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.
27 services27 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.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60416 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.

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 Jonathan Micetich's NPI number?

The NPI number for Jonathan Micetich is 1740273754. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Jonathan Micetich located?

Jonathan Micetich practices at 20 E North Street, Coal City, IL 60416. The listed phone number is (815) 634-4825.

What is Jonathan Micetich's specialty?

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

Is Jonathan Micetich enrolled in Medicare?

Yes. Jonathan Micetich 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 organization bills Medicare for Jonathan Micetich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Micetich reassigns Medicare benefits to Myeyedr Optometry Of Illinois, LLC (Coal City, IL). The 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 Jonathan Micetich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jonathan Micetich accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 4 other insurers list Jonathan Micetich 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 Jonathan Micetich was last updated on March 25, 2021. 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.