Individual provider Active NPI

Kelsey Peifer, DNP, FNP-BC, APRN

  • Nurse Practitioner
  • Sycamore, IL
National Provider Identifier
1437810876
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209024180 Issued in IL
Practice address
165 E Plank Rd
Sycamore, IL 60178-8757
Phone
(844) 599-3700
NPI assigned
Jan 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 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 209024180 IL Primary
Family Nurse Practitioner 363LF0000X 209024180 IL

Addresses

Primary practice location

165 E Plank Rd
Sycamore, IL 60178-8757

Mailing address

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone (630) 232-2200

Other practice location 1

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone (630) 232-2200

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
I20240830002933 IL Practitioner - Nurse Practitioner 8729461975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone (630) 232-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209024180ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Aug 4, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 4, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

2425 Fargo Blvd
Geneva, IL 60134
Phone (630) 232-2200

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: kelsey.peifer.p1@direct.gefcc.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1437810876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 FARGO BLVD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343591",
            "telephone_number": "630-232-2200",
            "fax_number": "630-232-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PLANK RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601788757",
            "telephone_number": "844-599-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 Fargo Blvd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601343591",
            "country_code": "US",
            "telephone_number": "630-232-2200",
            "fax_number": "630-232-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEIFER",
        "first_name": "KELSEY",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024180",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.