Individual provider Active NPI

Andrew Brian Armstrong, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Peoria, IL
National Provider Identifier
1033373311
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
11013223A Issued in IN
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone
(309) 672-4920
NPI assigned
Jul 15, 2008
Last updated
Mar 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 11013223A IN Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Mailing address

10524 N Trail View Dr
Dunlap, IL 61525-9773
Phone (309) 573-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110606000236 IL Practitioner - Pathology 5991982746 Reassigns benefits to 1 organization
I20180713002325 IA Practitioner - Pathology 5991982746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Ohio State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peoria Tazewell Pathology Group, S.C.Group PAC ID 1254228711, 17 clinicians

Practice addresses (Care Compare)

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4918

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-5286

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-2724

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11013223AINMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peoria Tazewell Pathology Group, S.C. Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2011 Accepting new patients

Locations

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

Organizations & group practices 1

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1033373311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10524 N TRAIL VIEW DR",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "615259773",
            "telephone_number": "309-573-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "ANDREW",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "11013223A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.