Individual provider Active NPI

Mandie L Nemeth, APN

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1467224113
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209028463 Issued in IL
Practice address
8940 N Wood Sage Rd
Peoria, IL 61615-7822
Phone
(309) 243-3000
Fax
(309) 243-3274
NPI assigned
Oct 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209028463 IL Primary

Addresses

Primary practice location

8940 N Wood Sage Rd
Peoria, IL 61615-7822

Mailing address

8940 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-3000

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
I20240124002617 IL Practitioner - Nurse Practitioner 1153774393 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Illinois Urologic Health Surgeons SCGroup PAC ID 0648209429, 11 clinicians
Oncology-Hematology Associates of Central Illinois P CGroup PAC ID 3870571649, 64 clinicians

Practice addresses (Care Compare)

2937 N Il Route 178
Unit 5
Utica, IL 61373-9708
Phone (815) 664-5367

8940 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Medical PLLC CurrentSince Dec 3, 2023 Accepting new patients
Oncology-Hematology Associates of Central Illinois P C CurrentSince Sep 16, 2024 Accepting new patients
Altea Medical Illinois PLLC CurrentSince Jan 6, 2024 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

1101 E State St
Geneva, IL 60134
Phone (630) 208-1876

1200 Starfire Dr
Ottawa, IL 61350
Phone (815) 434-9999

8940 N Wood Sage Rd
Peoria, IL 61615
Phone (309) 243-3610

555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880

101 E Via Ghiglieri
Toluca, IL 61369
Phone (815) 452-2367

Interoperability endpoints

  • Direct secure messaging: mandie.nemeth@ilcc.ikm.direct-ci.com

Organizations & group practices 4

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 4

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": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1467224113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-3000",
            "fax_number": "309-243-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-3000",
            "fax_number": "309-243-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMETH",
        "first_name": "MANDIE",
        "middle_name": "L",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-26",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209028463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.