Kim Treviranus

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

036061910 Issued in IL

Practice address

101 E Miller Rd
Sterling, IL 61081-1252

Phone

(815) 625-4790

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Pulmonary Disease

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Medicare reassignment Care Compare group NPD
• Sterling Rock Falls Clinic

  • Multi-Specialty Clinic/Center
  • Dixon, IL
  • NPI 1588746101
  NPD (past)
• Sterling Rock Falls Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Morrison, IL
  • NPI 1760564330
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1225118128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVIRANUS",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IL",
            "license": "036061910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9815737",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE MEDICAL",
            "identifier": "091400",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061910",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler J Thompson, CRNA
• Jeffrey Robert Thormeyer, M.D.
• Eric Thueson, CRNA
• Barbara E Tieman, APN
• Peter Toth, M.D.
• Angela Tschosik-Johnson, APRN
• Frank Tugwell, M.D.
• United Senior Properties of Sterling, LLC
• Jennifer Lyn Vance, PA
• Nirmal Varma, OTR/L

• Sleep Medicine (Internal Medicine) Physician in Sterling, IL
• Providers in Sterling, IL by specialty
• Sleep Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.

Verify at the official NPI Registry.