Active NPI
Marco Barzallo, M.D.
- Cardiovascular Disease Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036114162
- Practice address
- 5405 N Knoxville Ave
Peoria, IL 61614-5016 - Phone
- (309) 691-4410
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036114162 | IL | Primary |
Addresses
Primary practice location
5405 N Knoxville Ave
Peoria, IL 61614-5016
Mailing address
5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone (309) 691-4410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036114162 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-3141
1051 W S St
Kewanee, IL 61443-8354
Phone (309) 852-7500
111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311
3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000
3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161
3375 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 676-0766
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
- Osf Saint Luke Medical Center
- Graham Hospital Association
- St Mary Medical Center
- Carle Eureka Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 34 |
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036114162 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| Iowa Heart Center PC | Cardiovascular Disease | Past | Accepting new patients |
Locations
610 Park Ave
Pekin, IL 61554
Phone (309) 346-7776
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
-
- Cardiovascular Disease Physician
- West Des Moines, IA
- NPI 1164410932
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Eureka, IL
- NPI 1184644023
-
- Critical Access Hospital
- Kewanee, IL
- NPI 1871919381
-
- General Acute Care Hospital
- Galesburg, IL
- NPI 1164485363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329350400000",
"number": "1316971823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5405 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145016",
"telephone_number": "309-691-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145016",
"telephone_number": "309-691-4410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARZALLO",
"first_name": "MARCO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2012-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036114162",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036114162",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.