Dwight Pentzien, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-090963 Issued in IL

Practice address

1000 Health Center Dr
Mattoon, IL 61938-9261

Phone

(217) 258-2551

Fax

(217) 258-2256

NPI assigned

Aug 22, 2006

Last updated

Jan 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment NPD
• Sarah Bush Lincoln Health Center

  dba FCH Greenville Family Medicine Clinic

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1073629887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384693",
            "telephone_number": "217-238-6055",
            "fax_number": "217-258-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389261",
            "telephone_number": "217-258-2551",
            "fax_number": "217-258-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTZIEN",
        "first_name": "DWIGHT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-090963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preeti Patel, MD
• Tyrese Patterson, RSA
• Tanisha Patton
• Kimberly Dawn Peery, ANP
• Adrian Pelayo, RSA
• Kimberly Penza, SLPA
• Dominic Perrino, D.O.
• Petersen Health Care II, Inc (Palm Terrace of Mattoon)
• Petersen Management Company, LLC (Palm Terrace of Mattoon)
• Pharmax Inc. (dba Pharmax Pharmacy #0912)

• Emergency Medicine Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.