Thomas Kevin Brattain, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016003267 Issued in IL

Practice address

3322 W Willow Knolls Dr
Peoria, IL 61614-8148

Phone

(309) 691-5800

Fax

(309) 691-1336

NPI assigned

Jan 16, 2006

Last updated

Apr 3, 2008By the provider in NPPES

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 4

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1981

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)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  dba Physical Medicine & Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment NPD
• Illinois Valley Podiatry Group PC

  • Podiatrist
  • Peoria, IL
  • NPI 1750506846
  Authorized official Same address or phone
• Saint Francis Medical Center

  dba Saint Francis Medical Center Neurology

  • Neurology Physician
  • Peoria, IL
  • NPI 1154370195
  NPD
• Saint Francis Medical Center

  dba Saint Francis Home Health

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  dba Multiple Hospital Departments

  • Nurse Practitioner
  • Peoria, IL
  • NPI 1962456764
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1285613463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148148",
            "telephone_number": "309-691-5800",
            "fax_number": "309-691-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148148",
            "telephone_number": "309-691-5800",
            "fax_number": "309-691-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTAIN",
        "first_name": "THOMAS",
        "middle_name": "KEVIN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480009789",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003267",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0007215174",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "928270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joleen Bramer, OTR
• Matthew T Bramlet, MD
• Susan Brandolino
• Suzanne Brasche, LCSW
• Bernadine Brattain
• Becky L Braun, AUD
• Ann Lynn Braverman, DO
• Bravo Care of Peoria Inc (Rosewood Care Center of Peoria)
• Alana Bravo
• Breath of Life LTD

• Podiatrist in Peoria, IL
• Providers in Peoria, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.