Individual provider Active NPI

Aaron M McLean, PA

  • Medical Physician Assistant
  • Peoria, IL
National Provider Identifier
1154672822
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-004453 Issued in IL
Practice address
6000 N Allen Rd
Peoria, IL 61614-3294
Phone
(309) 691-1400
NPI assigned
Sep 21, 2012
Last updated
Apr 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-004453 IL Primary
Surgical Physician Assistant 363AS0400X 085-004453 IL

Addresses

Primary practice location

6000 N Allen Rd
Peoria, IL 61614-3294

Mailing address

6000 N Allen Rd
Peoria, IL 61614-3294
Phone (309) 691-1400

Other identifiers 1

IdentifierTypeStateIssuer
085-004453MedicaidIL

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
I20121222000016 IL Practitioner - Physician Assistant 2567615552 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-004453ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pekin Prohealth Inc CurrentSince Oct 30, 2020 Accepting new patients
Graham Hospital Association CurrentSince Jan 23, 2023 Accepting new patients
Graham Hospital Association CurrentSince Jan 23, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Feb 24, 2014 Accepting new patients
Proctor Health Systems CurrentSince Oct 30, 2020 Accepting new patients
Proctor Health Systems CurrentSince Oct 30, 2020 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Feb 24, 2014 Accepting new patients

Locations

210 W Walnut St
Canton, IL 61520
Phone (309) 647-5240

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

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

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1154672822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143294",
            "telephone_number": "309-691-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143294",
            "telephone_number": "309-691-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "AARON",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-004453",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085-004453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085-004453",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.