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Deactivated NPI 1699778456 Deactivated / Inactive NPI Male Practitioner

Dr. Gary L Blackman , OD

Optometrist • Taylorville, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gary Blackman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 24, 2005
NPI Deactivation Date July 09, 2018
Total Practice Duration ~13 Years of Practice (2005 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Gary Blackman, OD was a registered Optometrist practicing in Taylorville, IL. Throughout an active medical career spanning 13 years, Dr. Blackman provided care at the practice location at 16 MADERA COURT until profile deactivation on 2018-07-09.

Historical Medicare Part B clinical services included established patient complete exam of visual system, photography of the retina, new patient complete exam of visual system. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

16 Madera Court

Taylorville, IL 625681213

Telephone 2175537709
Fax 2173035424
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Taylorville, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
4 Specialists

Practicing in Taylorville, IL (2783 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
10.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
110 108 $121.65 $113.85
92250 Photography of the retina
33 33 $76.00 $51.04
92004 New patient complete exam of visual system
22 22 $146.45 $136.98
92012 Established patient problem focused exam of visual system
19 19 $84.05 $79.22
92100 Multiple measurements of eye fluid pressure over an extended time period
15 15 $77.87 $72.46

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License IL 046006087

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 09, 2018

Record deactivated on July 09, 2018

NPI Profile Active January 23, 2012

NPI status registered as active in NPPES database

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Updated Practice Location January 23, 2012

Registered at 16 MADERA COURT, TAYLORVILLE, IL 625681213 (Tel: 2175537709)

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Updated Business Mailing Address January 23, 2012

Registered at 16 MADERA CT, TAYLORVILLE, IL 625688927 (Tel: 2175537709)

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Provider Name / Credentials Updated January 23, 2012

Recorded as GARY BLACKMAN, OD

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 23, 2012

Optometrist (License #046006087 in IL)

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Initial NPI Registration & Enumeration May 24, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699778456
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2005
Last Update: January 23, 2012
Deactivation Date: July 09, 2018

Mailing Address

16 Madera Ct

Taylorville, IL 625688927

Phone: 2175537709

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.