Individual provider Active NPI

Peter Stephen Cenek, APN-CNS

  • Adult Health Clinical Nurse Specialist
  • Peoria, IL
National Provider Identifier
1245526250
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
209-005473 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2000
NPI assigned
Jun 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 209-005473 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
Phone (309) 655-2000

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
I20140602000441 IL Practitioner - Nurse Practitioner 3476776915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

200 E Pennsylvania Ave
Suite 101
Peoria, IL 61603-3084
Phone (309) 655-7888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-005473ILMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients

Locations

200 E Pennsylvania Ave
Ste 101
Peoria, IL 61603
Phone (309) 655-7888

200 E Pennsylvania Ave
Peoria, IL 61603
Phone (309) 624-4000

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 2

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1245526250",
    "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",
            "telephone_number": "309-655-2000"
        },
        {
            "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": "CENEK",
        "first_name": "PETER",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "APN-CNS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209-005473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.