Anthony V Deceanne, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016004489 Issued in IL

Practice address

5017 N Glen Park Place Rd
Peoria, IL 61614-4677

Phone

(309) 691-1589

Fax

(309) 692-2032

NPI assigned

Jul 19, 2005

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

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Acpm Podiatry Group, LTD

  • Foot & Ankle Surgery Podiatrist
  • Peoria, IL
  • NPI 1730261363
  Medicare reassignment Authorized official
• Podiatric Management Systems LLC

  • Primary Podiatric Medicine Podiatrist
  • Lake Zurich, IL
  • NPI 1396968053

  Foot & Ankle Surgery

  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1083613293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 W DETWEILLER DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152116",
            "telephone_number": "309-689-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 N GLEN PARK PLACE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144677",
            "telephone_number": "309-691-1589",
            "fax_number": "309-692-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECEANNE",
        "first_name": "ANTHONY",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004489",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenelle Deatherage, PT
• Elizabeth Debernardi, PT
• Deborah Simonis LCSW
• Alan Debord, MD
• James R Debord, MD
• Arleta Dedianous, APRN
• Fizza Deen, MD
• Erica M Deford, PA
• Jason Deford, LCPC
• Lori A. Defreese, APN

• Foot & Ankle Surgery Podiatrist in Peoria, IL
• Providers in Peoria, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.