Individual provider Active NPI

Alger Penas, NP

  • Nurse Practitioner
  • Champaign, IL
National Provider Identifier
1053850586
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209015192 Issued in IL
Practice address
2300 S 1St St
Champaign, IL 61820-7661
Phone
(217) 383-9400
Fax
(217) 383-9691
NPI assigned
Feb 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209015192 IL Primary

Addresses

Primary practice location

2300 S 1St St
Champaign, IL 61820-7661

Mailing address

611 W Park St
BWPC
Urbana, IL 61801-2529
Phone (217) 383-6941

Other practice location 1

2300 S 1st St
Champaign, IL 61820-7661
Phone (217) 383-9400

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
I20170508000867 IL Practitioner - Nurse Practitioner 1153608880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2300 S 1St St
Champaign, IL 61820-7661
Phone (217) 383-9400

516 W Madison St
Danville, IL 61832-5657

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209015192ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 3, 2023 Accepting new patients
Carle Health Care Incorporated CurrentSince Apr 4, 2017 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 3, 2023 Accepting new patients
The Carle Foundation Hospital Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

2300 S 1st St
Champaign, IL 61820
Phone (217) 383-9400

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 7

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 2

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": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1053850586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 1ST ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207661",
            "telephone_number": "217-383-9400",
            "fax_number": "217-383-9691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618207661",
            "country_code": "US",
            "telephone_number": "217-383-9400",
            "fax_number": "217-383-9691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENAS",
        "first_name": "ALGER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.