Individual provider Active NPI

John M Quinones, DO

  • Family Medicine Physician
  • Pekin, IL
National Provider Identifier
1063520021
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036071254 Issued in IL
Practice address
1800 Broadway St
Pekin, IL 61554-3822
Phone
(309) 346-3416
Fax
(309) 346-3449
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-071254 IL
Family Medicine Physician 207Q00000X 036071254 IL Primary

Addresses

Primary practice location

1800 Broadway St
Pekin, IL 61554-3822

Mailing address

1800 Broadway St
Pekin, IL 61554-3822
Phone (309) 346-3416

Other identifiers 9

IdentifierTypeStateIssuer
02922981OtherILBCBS
071254OtherILOSF HEALTHPLANS
014156OtherILHEALTH ALLIANCE
036071254MedicaidIL
200397OtherILBLACK LUNG
180740OtherILHEALTH LINK
IL0103OtherILJOHN DEERE
0062839OtherILUMWA
1942315197OtherILNPI CLINIC NUMBER

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
I20050121000328 IL Practitioner - Family PracticePractitioner - Emergency Medicine 5597714014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-071254ILMDEmergency Medicine Physician
036071254ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Current Accepting new patients
Methodist Medical Center of Illinois Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Mason Hospital District Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Apr 1, 2015 Accepting new patients
Graham Services Corporation Family Medicine Past Accepting new patients

Locations

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

615 N Promenade St
Havana, IL 62644
Phone (309) 543-8510

1800 Broadway St
Pekin, IL 61554
Phone (309) 346-3416

5401 N Knoxville Ave
Ste 204
Peoria, IL 61614
Phone (309) 683-1200

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

815 Main St
Ste A1
Peoria, IL 61602

815 Main St
Peoria, IL 61602
Phone (309) 672-4908

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

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

Organizations & group practices 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1063520021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BROADWAY ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543822",
            "telephone_number": "309-346-3416",
            "fax_number": "309-346-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BROADWAY ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543822",
            "telephone_number": "309-346-3416",
            "fax_number": "309-346-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-071254",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036071254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02922981",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSF HEALTHPLANS",
            "identifier": "071254",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "014156",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071254",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "200397",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "180740",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0103",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0062839",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI CLINIC NUMBER",
            "identifier": "1942315197",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

Verify at the official NPI Registry.