Individual provider Active NPI

Adel F Mina, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Peoria, IL
National Provider Identifier
1316962749
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036111050 Issued in IL
Practice address
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone
(309) 672-4670
NPI assigned
Jul 13, 2006
Last updated
May 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036111050 IL
Cardiovascular Disease Physician 207RC0000X 036111050 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 036111050 IL Primary

Addresses

Primary practice location

112 NE Crescent Ave
Peoria, IL 61606-1901

Mailing address

112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670

Other practice location 1

2525 S Michigan Ave
Chicago, IL 60616-2333
Phone (312) 567-2000

Other identifiers 1

IdentifierTypeStateIssuer
036111050OtherILLICENSE

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
I20041101000320 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Emergency MedicinePractitioner - Other (Physician) 5193786572 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians

Practice addresses (Care Compare)

112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670

1302 N Greenwood St
Spring Valley, IL 61362-1576
Phone (779) 323-8150

1506 W Garfield Ave
Bartonville, IL 61607-1755
Phone (309) 697-2416

1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-4343

201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 444-3627

2076 N Main St
Canton, IL 61520-1054
Phone (309) 674-6090

209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 643-6185

221 NE Glen Oak Ave
Peoria, IL 61636-0001

2338 W Van Winkle Way
FL 3
Peoria, IL 61615-7483
Phone (309) 693-2020

2338 W Van Winkle Way
Suite 1100
Peoria, IL 61615-7401
Phone (309) 672-4670

5401 N Knoxville Ave
Peoria, IL 61614-5021

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

600 S 13TH St
Pekin, IL 61554-4936

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

901 W Walnut St
Metamora, IL 61548-8637
Phone (309) 367-4144

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036111050ILMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Internal Medicine CurrentSince Feb 7, 2015 Accepting new patients
Carle Health Medical Group Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 1, 2009 Accepting new patients
Methodist Medical Center of Illinois Internal Medicine CurrentSince Aug 1, 2009 Accepting new patients
Proctor Health Systems CurrentSince Feb 7, 2015 Accepting new patients
Pekin Prohealth Inc Internal Medicine CurrentSince Oct 3, 2017 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Mercy Clinic Joplin LLC Internal Medicine Past Accepting new patients
Sjmgroup Past Accepting new patients

Locations

1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 671-7779

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: aminamd388487@carlehiedirect.net

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1316962749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NE CRESCENT AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061901",
            "telephone_number": "309-672-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NE CRESCENT AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061901",
            "telephone_number": "309-672-4670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162333",
            "country_code": "US",
            "telephone_number": "312-567-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINA",
        "first_name": "ADEL",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036111050",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036111050",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036111050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036111050",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.