Active NPI
Victoria Grisyuk
- Foot & Ankle Surgery Podiatrist
- Peoria, IL
National Provider Identifier
1588551485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 135001268
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (309) 655-2000
- NPI assigned
- Jun 23, 2025
- Last updated
- Jul 15, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 135001268 | 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
Phone (309) 655-2323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135001268 | IL | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1588551485",
"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",
"telephone_number": "309-655-2323"
},
{
"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": "309-655-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISYUK",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-23",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "135001268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.