Individual provider Active NPI

Lee T Kinsinger, MD

  • Family Medicine Physician
  • Washington, IL
National Provider Identifier
1417983487
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-082346 Issued in IL
Practice address
201 N Cummings LN
Washington, IL 61571-2181
Phone
(309) 444-3627
Fax
(309) 444-7158
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-082346 IL Primary

Addresses

Primary practice location

201 N Cummings LN
Washington, IL 61571-2181

Mailing address

201 N Cummings LN
P.O. Box 369
Washington, IL 61571-2181
Phone (309) 444-3627

Other identifiers 1

IdentifierTypeStateIssuer
036-082346MedicaidIL

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
I20100611000728 IL Practitioner - Family Practice 9830104397 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-082346ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Family Medicine CurrentSince Jan 30, 2017 Accepting new patients
Proctor Health Systems CurrentSince Jan 30, 2017 Accepting new patients
Proctor Health Systems Family Medicine Current Accepting new patients

Locations

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

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

201 N Cummings Ln
#369
Washington, IL 61571
Phone (309) 444-3627

201 N Cummings Ln
Washington, IL 61571
Phone (309) 370-6406

201 N Cummings Ln
Ste A
Washington, IL 61571
Phone (309) 444-3627

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1417983487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CUMMINGS LN",
            "address_2": "P.O. BOX 369",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-444-3627",
            "fax_number": "309-444-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-444-3627",
            "fax_number": "309-444-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSINGER",
        "first_name": "LEE",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-082346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-082346",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

Verify at the official NPI Registry.