Individual provider Active NPI

Melinda Bahler

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1033608872
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017573 Issued in IL
Practice address
900 Main St Ste 630
Peoria, IL 61602-5024
Phone
(309) 672-4433
NPI assigned
May 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 209017573 IL
Nurse Practitioner 363L00000X 209017573 IL Primary

Addresses

Primary practice location

900 Main St Ste 630
Peoria, IL 61602-5024

Mailing address

900 Main St Ste 630
Peoria, IL 61602-5024
Phone (309) 672-4433

Other identifiers 1

IdentifierTypeStateIssuer
209017573OtherILLICENSE

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
I20180803000884 IL Practitioner - Nurse Practitioner 1355699521 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209017573ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Nurse Practitioner CurrentSince Jun 18, 2018 Accepting new patients
Pekin Prohealth Inc CurrentSince Aug 20, 2021 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 1, 2023 Accepting new patients
Proctor Health Systems CurrentSince Jun 18, 2018 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Proctor Health Systems Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jun 18, 2018 Accepting new patients
Proctor Health Systems CurrentSince Jun 18, 2018 Accepting new patients

Locations

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

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

900 Main St
Ste 630
Peoria, IL 61602
Phone (309) 627-4433

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1033608872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 630",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025024",
            "telephone_number": "309-672-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 630",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025024",
            "telephone_number": "309-672-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHLER",
        "first_name": "MELINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209017573",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209017573",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.