Individual provider Active NPI

Matya Leann Riley, FNP-C

  • Family Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1013541143
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209020952 Issued in IL
Practice address
151 N Main St
Decatur, IL 62523-1206
Phone
(217) 362-6262
Fax
(217) 362-6290
NPI assigned
Feb 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209020952 IL Primary

Addresses

Primary practice location

151 N Main St
Decatur, IL 62523-1206

Mailing address

151 N Main St
Decatur, IL 62523-1206
Phone (217) 362-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310001324 IL Practitioner - Nurse Practitioner 3274949698 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Illinois LLCGroup PAC ID 2264747344, 38 clinicians
Complexcare Medical Group Midwest M PLLCGroup PAC ID 1355858630, 87 clinicians

Practice addresses (Care Compare)

1530 N Randall Rd
Suite 210
Elgin, IL 60123-7879
Phone (224) 760-7322

716 18TH St
Charleston, IL 61920-2382
Phone (248) 660-1220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Health Physicians Group LTD CurrentSince Mar 1, 2021 Accepting new patients
Heritage Behavioral Health Center Inc. CurrentSince Dec 4, 2023 Accepting new patients
Heritage Behavioral Health Center, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Mar 1, 2021 Accepting new patients
Chestnut Health of Illinois LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

25 W Lincoln Ave
Charleston, IL 61920
Phone (217) 345-9600

151 N Main St
Decatur, IL 62523
Phone (217) 420-4776

1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Interoperability endpoints

  • Direct secure messaging: matya.riley.d1.p32@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1013541143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "217-362-6262",
            "fax_number": "217-362-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231206",
            "telephone_number": "217-362-6262",
            "fax_number": "217-362-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MATYA",
        "middle_name": "LEANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.