Individual provider Active NPI

Michael Lindahl

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1144635905
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125065931 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2000
NPI assigned
Jun 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125065931 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170728000335 TX Practitioner - Emergency Medicine 2466766134 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Physician Resources, LLPGroup PAC ID 7012161375, 91 clinicians

Practice addresses (Care Compare)

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 947-8181

Hospital & facility affiliations

  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
Texas Physician Resources, LLP Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2017 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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 1

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1144635905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDAHL",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125065931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.