Active NPI
Samuel Brian McIntyre, ED.D
- Health Service Psychologist
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- Practice address
- 7309 N Knoxville Ave
Peoria, IL 61614-2085 - Phone
- (309) 692-9898
- Fax
- (309) 692-9055
- NPI assigned
- Apr 12, 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 |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | IL | Primary |
Addresses
Primary practice location
7309 N Knoxville Ave
Peoria, IL 61614-2085
Mailing address
7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone (309) 692-9898
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-3173
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.28 of 100
- Quality
- 73.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.73
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071003851 | IL | MD | Health Service Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Board of Trustees of the University of Illinois | Current | Accepting new patients |
Locations
7694 Solutions Ctr
Chicago, IL 60677
900 Main St
Ste 720
Peoria, IL 61602
Phone (309) 495-1640
1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000
Interoperability endpoints
- smcintyremd397197@carlehiedirect.net
Organizations & group practices 3
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.
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
dba Medical Service Plan at Peoria
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
-
dba Occupational Health Service Institute (OHSI)
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1386608008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7309 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142085",
"telephone_number": "309-692-9898",
"fax_number": "309-692-9055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7309 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142085",
"telephone_number": "309-692-9898",
"fax_number": "309-692-9055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "SAMUEL",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "ED.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jul 13, 2026; 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.