| Dr Keith Lyston, OD | |
|
3300 Godfrey Rd, Godfrey, IL 62035-2558 | |
| (618) 466-8787 | |
| (618) 466-4703 |
| Full Name | Dr Keith Lyston |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 33 Years |
| Location | 3300 Godfrey Rd, Godfrey, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861614810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | TO3050 (Missouri) | Secondary |
| 152W00000X | Optometrist | 046008572 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rose Optical, Inc. | 2961586805 | 4 |
| Associated Vision Care, Ltd | 9133593460 | 3 |
| Provider Name | Rose Optical, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669444063 PECOS PAC ID: 2961586805 Enrollment ID: O20080229000685 |
| Provider Name | Associated Vision Care, Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1689370827 PECOS PAC ID: 9133593460 Enrollment ID: O20230328000701 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Keith Lyston, OD 3300 Godfrey Rd, Godfrey, IL 62035-2558 Ph: (618) 466-8787 | Dr Keith Lyston, OD 3300 Godfrey Rd, Godfrey, IL 62035-2558 Ph: (618) 466-8787 |
Bradley D Martinson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Adeyinka A Adewale, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Dr. Mark Edward Ferguson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Rose Optical, Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Andrew Ibisch, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1310 Dadrian Prof Park, Godfrey, IL 62035 Phone: 618-433-5005 Fax: 618-467-1053 | |
Ron Loflin, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 | |
Illini Optometric Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 |