NPIMap

Individual provider Active NPI

Stephen C Priebe, PAC

  • Physician Assistant
  • Pinckneyville, IL
National Provider Identifier
1497727937
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001455 Issued in IL
Practice address
5383 State Route 154
Pinckneyville, IL 62274-3342
Phone
(618) 357-2187
Fax
(618) 357-8888
NPI assigned
Feb 7, 2006
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001455 IL Primary

Addresses

Primary practice location

5383 State Route 154
Pinckneyville, IL 62274-3342

Mailing address

5383 State Route 154
Pinckneyville, IL 62274-3342
Phone (618) 357-2187

Other identifiers 1

IdentifierTypeStateIssuer
970015885OtherILMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spriebe@direct.pvillehosp.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000743 IL Practitioner - Physician Assistant 9537327192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinckneyville Community HospitalGroup PAC ID 8123921632, 26 clinicians

Practice addresses (Care Compare)

5383 State Route 154
Pinckneyville, IL 62274-3342
Phone 61835721875902

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinckneyville Community Hospital CurrentSince Dec 1, 2025 Accepting new patients

Locations

5383 State Route 154
Pinckneyville, IL 62274
Phone (618) 357-2131

Interoperability endpoints

  • Direct secure messaging: spriebe@direct.pvillehosp.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1497727937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5383 STATE ROUTE 154",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622743342",
            "telephone_number": "618-357-2187",
            "fax_number": "618-357-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5383 STATE ROUTE 154",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622743342",
            "telephone_number": "618-357-2187",
            "fax_number": "618-357-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEBE",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970015885",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spriebe@direct.pvillehosp.org",
            "affiliation": "N",
            "endpointDescription": "Family Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Clinical Summary, TOC, CCD",
            "address_1": "5383 State Route 154",
            "city": "Pinckneyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622743342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pinckneyville, IL

Sources for this page

Verify at the official NPI Registry.