Lauren M Petoskey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-005301 Issued in IL

Practice address

8600 N State Route 91
Peoria, IL 61615-9541

Phone

(309) 683-5050

Fax

(309) 683-5335

NPI assigned

Oct 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lauren M Bergstresser Former name

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Mary Medical CenterGroup PAC ID 8628038015, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Home Health-Western Region Home health agency, Galesburg, IL, CCN 147430
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Osf Holy Family Medical Center Hospital, Monmouth, IL, CCN 141318

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• St Mary Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Galesburg, IL
  • NPI 1962467670
  Medicare reassignment Care Compare group
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• St Mary Medical Center

  • Rural Health Clinic/Center
  • Galesburg, IL
  • NPI 1275234965
  NPD
• St Mary Medical Center

  • Family Medicine Physician
  • Galesburg, IL
  • NPI 1457308710

  Physician Assistant

  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• St Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  • Critical Access Hospital
  • Monmouth, IL
  • NPI 1548393184
  Care Compare affiliation
• St Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation
• St Mary Medical Center

  • Home Health Agency
  • Galesburg, IL
  • NPI 1225072176
  Care Compare affiliation

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1285037929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 N STATE ROUTE 91",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159541",
            "telephone_number": "309-683-5050",
            "fax_number": "309-683-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 N STATE ROUTE 91",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159541",
            "telephone_number": "309-683-5050",
            "fax_number": "309-683-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETOSKEY",
        "first_name": "LAUREN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BERGSTRESSER",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Alyssa Peterson, DO
• Jaimie M Peterson
• Sarah Peterson
• Thitapa Petlerkwong, DO
• Collin Petoskey, D.D.S.
• Channing Petrak, MD
• Cindy Pettit, DNP, FNP-BC
• Nicholas Peyton, ATC
• Maci Pfeffer
• Eric L. Pfeiffer, APN

• Physician Assistant in Peoria, IL
• Providers in Peoria, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.