Active NPI
Thanad S Shay, M.D.
- Cardiovascular Disease Physician
- Peoria, IL
National Provider Identifier
1174672331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036048357
- Practice address
- 1201 N North St
Peoria, IL 61606-1533 - Phone
- (309) 671-2310
- Fax
- (309) 674-3560
- NPI assigned
- Jan 9, 2007
- Last updated
- Sep 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036048357 | IL | Primary |
Addresses
Primary practice location
1201 N North St
Peoria, IL 61606-1533
Mailing address
1201 N North St
Peoria, IL 61606-1533
Phone (309) 671-2310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036048357 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1967
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1201 N N St
Peoria, IL 61606-1533
Phone (309) 671-2310
Hospital & facility affiliations
- Carle Health Methodist Hospital
- Saint Francis Medical Center
- Carle Health Proctor Hospital
- Carle Health Pekin Hospital
- Osf Saint Elizabeth MDL Ctr
Merit-based Incentive Payment System (MIPS)
- Final score
- 20.74 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 69.14
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036048357 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Shay and Associates, LTD. | Cardiovascular Disease | Current | Accepting new patients |
Locations
1201 N North St
Peoria, IL 61606
Phone (309) 671-2103
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Peoria, IL
- NPI 1275682445
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
dba OSF Saint Elizabeth Medical Center
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
-
dba Proctor Hospital
- General Acute Care Hospital
- Peoria, IL
- NPI 1033116876
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1134826894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1174672331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 N NORTH ST",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061533",
"telephone_number": "309-671-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 N NORTH ST",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061533",
"telephone_number": "309-671-2310",
"fax_number": "309-674-3560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAY",
"first_name": "THANAD",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036048357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036048357",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.