Individual provider Active NPI

Matt J Kriebs, APRN, FNP-BC

  • Family Nurse Practitioner
  • Oakbrook Terrace, IL
National Provider Identifier
1194367912
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.020057 Issued in IL
Practice address
18W140 Butterfield Rd FL 15
Oakbrook Terrace, IL 60181-4843
Phone
(904) 490-0264
NPI assigned
Oct 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.020057 IL Primary

Addresses

Primary practice location

18W140 Butterfield Rd FL 15
Oakbrook Terrace, IL 60181-4843

Mailing address

PO Box 516
Oregon, IL 61061-0516
Phone (904) 490-0264

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
I20191205002347 IL Practitioner - Nurse Practitioner 6103259130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiorenal Therapeutics of Illinois PLLCGroup PAC ID 5395159677, 32 clinicians

Practice addresses (Care Compare)

18 W140 Butterfield Rd
Suite 1558
Oakbrook Terrace, IL 60181-4843
Phone (904) 490-0264

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.020057ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiorenal Therapeutics of Illinois PLLC CurrentSince Feb 1, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1194367912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610610516",
            "telephone_number": "904-490-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18W140 BUTTERFIELD RD FL 15",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814843",
            "telephone_number": "904-490-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEBS",
        "first_name": "MATT",
        "middle_name": "J",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.