Individual provider Active NPI

Jordan Cascante, DO

  • Internal Medicine Physician
  • Peoria, IL
National Provider Identifier
1518522705
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.160980 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(405) 795-0557
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OP61422983 WA
Student in an Organized Health Care Education/Training Program 390200000X 00000000000000000000 IL
Internal Medicine Physician 207R00000X 036.160980 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230803000374 WA Practitioner - Internal Medicine 9335477108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.160980ILMDInternal Medicine Physician
00000000000000000000ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Internal Medicine CurrentSince Jan 6, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

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 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": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1518522705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "405-795-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASCANTE",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP61422983",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "00000000000000000000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.160980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.