Individual provider Active NPI

Lindsey Pastorik, APN

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1396397220
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209019588 Issued in IL
Practice address
10408 N Centerway Dr Ste Cde
Peoria, IL 61615-1234
Phone
(309) 308-5100
Fax
(309) 308-5101
NPI assigned
Jul 11, 2019
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209019588 IL
Family Nurse Practitioner 363LF0000X 209019588 IL Primary

Addresses

Primary practice location

10408 N Centerway Dr Ste Cde
Peoria, IL 61615-1234

Mailing address

10408 N Centerway Dr Ste Cde
Peoria, IL 61615-1234
Phone (309) 308-5100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190801000410 IL Practitioner - Nurse Practitioner 6507192309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

330 SW Adams St
Peoria, IL 61602-1502
Phone (309) 655-2877

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209019588ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa Regional Hospital & Healthcare Center Current Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince May 23, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 11, 2019 Accepting new patients
Osf Multi-Specialty Group Past Accepting new patients

Locations

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

1614 E Norris Dr
Ottawa, IL 61350
Phone (815) 433-1010

124 SW Adams St
Fl 2
Peoria, IL 61602
Phone (309) 655-2850

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

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

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1396397220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10408 N CENTERWAY DR STE CDE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151234",
            "telephone_number": "309-308-5100",
            "fax_number": "309-308-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10408 N CENTERWAY DR STE CDE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151234",
            "telephone_number": "309-308-5100",
            "fax_number": "309-308-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTORIK",
        "first_name": "LINDSEY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019588",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.