Individual provider Active NPI

Robert A Meister, M.D.

  • Internal Medicine Physician
  • Peoria, IL
National Provider Identifier
1114992229
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036080929 Issued in IL
Practice address
5401 N Knoxville Ave
Suite 204
Peoria, IL 61614-5098
Phone
(309) 683-1200
Fax
(309) 691-1705
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036080929 IL Primary

Addresses

Primary practice location

5401 N Knoxville Ave
Suite 204
Peoria, IL 61614-5098

Mailing address

5401 N Knoxville Ave
Suite 204
Peoria, IL 61614-5098
Phone (309) 683-1200

Other identifiers 1

IdentifierTypeStateIssuer
036080929MedicaidIL

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
I20100719000411 IL Practitioner - Internal Medicine 5890827349 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Internal Medicine Current Accepting new patients
Proctor Health Systems CurrentSince Jan 1, 2003 Accepting new patients
Proctor Health Systems CurrentSince Jan 1, 2003 Accepting new patients

Locations

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

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

Organizations & group practices 3

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1114992229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 204",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-683-1200",
            "fax_number": "309-691-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "address_2": "SUITE 204",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-683-1200",
            "fax_number": "309-691-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEISTER",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036080929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080929",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.