Individual provider Active NPI

Thomas Pliura, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Normal, IL
National Provider Identifier
1124054010
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
036-069013 Issued in IL
Practice address
Virginia & Franklin Streets
Normal, IL 61761
Phone
(309) 827-4321
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036-069013 IL Primary

Addresses

Primary practice location

Virginia & Franklin Streets
Normal, IL 61761

Mailing address

RR 2 Box 130
Le Roy, IL 61752-9541

Other identifiers 2

IdentifierTypeStateIssuer
036069013-1MedicaidIL
05721369OtherILBC/BS

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
I20060227000622 IL Practitioner - Emergency Medicine 0648241208 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-069013ILMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integritas Emergency Physician Services, LLC CurrentSince Sep 1, 2013 Accepting new patients
Bloomington Medical Laboratory Physicians, S.C. Current Accepting new patients
Marion Emergency Physicians, LLC Past Accepting new patients
Danville Healthcare, LLC PastSince Mar 1, 2000 Accepting new patients
Prairie Emergency Group, LTD. Emergency Medical Services Past Accepting new patients
Central Illinois Neuroradiology, LTD Past Accepting new patients
Ecare Emergency Physicians PastSince May 1, 2000 Accepting new patients

Locations

517 N Main St
Anna, IL 62906
Phone (618) 833-2295

2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

Organizations & group practices 7

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1124054010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 130",
            "city": "LE ROY",
            "state": "IL",
            "postal_code": "617529541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VIRGINIA & FRANKLIN STREETS",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-827-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLIURA",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036-069013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069013-1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "05721369",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.