Individual provider Active NPI

Anthony J Buecker, M.D.

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1043504368
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.133966 Issued in IL
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-5408
Phone
(309) 672-5500
NPI assigned
Jun 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.133966 IL Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-5408

Mailing address

10814 N Autumn TRL
Brimfield, IL 61517-9716
Phone (309) 370-5382

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-5408
Phone (309) 655-2109

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141027000586 IL Practitioner - Emergency Medicine 0648491118 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.133966ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System CurrentSince Jun 14, 2014 Accepting new patients
Bloomington Medical Laboratory Physicians, S.C. Current Accepting new patients
Saint James Hospital CurrentSince May 1, 2019 Accepting new patients
St Joseph Medical Center Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 1, 2023 Accepting new patients
Osf Healthcare System Current Accepting new patients
Saint James Hospital CurrentSince May 1, 2019 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Osf Healthcare System Emergency Medicine CurrentSince Jun 14, 2014 Accepting new patients
St Joseph Medical Center CurrentSince May 1, 2019 Accepting new patients
Osf Multi-Specialty Group CurrentSince Dec 1, 2020 Accepting new patients
Osf Healthcare System Current Accepting new patients
St Joseph Medical Center Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 1, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

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

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

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

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

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

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1043504368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10814 N AUTUMN TRL",
            "city": "BRIMFIELD",
            "state": "IL",
            "postal_code": "615179716",
            "telephone_number": "309-370-5382"
        },
        {
            "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": "616365408",
            "telephone_number": "309-672-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616375408",
            "country_code": "US",
            "telephone_number": "309-655-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUECKER",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.133966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.