Individual provider Active NPI

Brandon Bernard Bleess, MD

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1306284161
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036138942 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-1014
Phone
(309) 655-2000
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036138942 IL
Emergency Medicine Physician 207P00000X 036138942 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-1014

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-0174

Other practice location 1

400 S Kingshighway Blvd
Saint Louis, MO 63110-1014
Phone (314) 362-9123

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160527000120 IL Practitioner - Emergency Medicine 3779804612 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036138942ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center Emergency Medical Services CurrentSince Sep 5, 2017 Accepting new patients
Saint Francis Medical Center Emergency Medical Services CurrentSince Dec 13, 2016 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2021 Accepting new patients
St Joseph Medical Center CurrentSince Jun 1, 2018 Accepting new patients
Saint Francis Medical Center CurrentSince Dec 13, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Bloomington Medical Laboratory Physicians, S.C. Current Accepting new patients
Saint Francis Medical Center Current Accepting new patients
St Joseph Medical Center Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
St Joseph Medical Center Current Accepting new patients
St Mary Medical Center CurrentSince Sep 5, 2017 Accepting new patients

Locations

812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

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

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

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

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

Organizations & group practices 11

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1306284161",
    "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": "309-624-0174",
            "fax_number": "309-655-2602"
        },
        {
            "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": "616371014",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S Kingshighway Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101014",
            "country_code": "US",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEESS",
        "first_name": "BRANDON",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036138942",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036138942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.