Individual provider Active NPI

Derek Pechacek, FNP-C

  • Family Nurse Practitioner
  • O Fallon, IL
National Provider Identifier
1114356607
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-010889 Issued in IL
Practice address
320 E Highway 50
O Fallon, IL 62269-2704
Phone
(618) 624-3368
Fax
(618) 624-3387
NPI assigned
Nov 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209-010889 IL Primary

Addresses

Primary practice location

320 E Highway 50
O Fallon, IL 62269-2704

Mailing address

2804 Lakeside Dr
Columbia, IL 62236-2681

Other practice location 1

1300 N Market St
Sparta, IL 62286-1048
Phone (618) 443-4138

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nch@spartahospital.hin.us

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
I20131230000978 IL Practitioner - Nurse Practitioner 9234366980 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Emergency Good Samaritan, IncGroup PAC ID 1658529342, 28 clinicians
Midwest Emergency Anderson Health IncGroup PAC ID 8022401256, 33 clinicians
Washington County Hospital DistrictGroup PAC ID 4880599844, 21 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

705 S Grand
Nashville, IL 62263-1534

705 S Grand St
Nashville, IL 62263-1534
Phone (618) 327-8236

Hospital & facility affiliations

  • Washington County Hospital Hospital, Nashville, IL, CCN 141308
  • Washington County Hospital Nursing home, CCN 14Z308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-010889ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Sparta Community Hospital D/B/a Quality Healthcare Clinics CurrentSince Oct 1, 2024 Accepting new patients
Sparta Community Hospital D/B/a Quality Healthcare Clinics Past Accepting new patients
Sparta Community Hospital D/B/a Quality Healthcare Clinics Past Accepting new patients

Locations

211 S 3rd St
Belleville, IL 62220
Phone (618) 234-2700

159 E McArthur Dr
Bethalto, IL 62010
Phone (618) 258-7380

1103 Belt Line Rd
Collinsville, IL 62234
Phone (618) 344-2273

3417 Anderson Healthcare Dr
Edwardsville, IL 62025
Phone (618) 288-4929

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

1300 N Market St
Sparta, IL 62286
Phone (618) 443-4138

207 S Burns Ave
Sparta, IL 62286
Phone (618) 443-3084

400 N Caldwell St
Staunton, IL 62088
Phone (618) 635-2200

108 W US Highway 40
Troy, IL 62294
Phone (618) 391-5065

Interoperability endpoints

  • Direct secure messaging: nch@spartahospital.hin.us
  • Direct secure messaging: dpechacek236185@direct-ehr-ssmhc.com
  • Direct secure messaging: pechaced@yourcarecommunity.org

Organizations & group practices 10

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 3

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": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1114356607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 LAKESIDE DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692704",
            "telephone_number": "618-624-3368",
            "fax_number": "618-624-3387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 N Market St",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "IL",
            "postal_code": "622861048",
            "country_code": "US",
            "telephone_number": "618-443-4138",
            "fax_number": "618-443-3685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECHACEK",
        "first_name": "DEREK",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-010889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nch@spartahospital.hin.us",
            "affiliation": "N",
            "address_1": "1300 N Market St",
            "city": "Sparta",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622861048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.