Individual provider Active NPI

Joseph J Sarmiento III, MD

  • Clinical Cardiac Electrophysiology Physician
  • Peoria, IL
National Provider Identifier
1588691877
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036-070719 Issued in IL
Practice address
5405 North Knoxville Avenue
Peoria, IL 61614
Phone
(309) 691-4410
Fax
(309) 589-2830
NPI assigned
Jun 26, 2006
Last updated
Aug 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036070719 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 036-070719 IL Primary

Addresses

Primary practice location

5405 North Knoxville Avenue
Peoria, IL 61614

Mailing address

5405 North Knoxville Avenue
Peoria, IL 61614
Phone (309) 691-4410

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050224000985 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 6002728441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Northwestern University Feinberg Medical School, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1050 E Norris Dr
Suite 2C
Ottawa, IL 61350-1611
Phone (815) 434-0276

1051 W S St
Kewanee, IL 61443-8354
Phone (309) 852-7500

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036070719ILMDCardiovascular Disease Physician
036-070719ILMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Cardinal Medical Group, LTD. Past Accepting new patients

Locations

1505 Eastland Dr
Ste 110
Bloomington, IL 61701
Phone (309) 662-8231

610 Park Ave
Pekin, IL 61554
Phone (309) 346-7776

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

5405 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-4410

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1588691877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 NORTH KNOXVILLE AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-4410",
            "fax_number": "309-589-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 NORTH KNOXVILLE AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-4410",
            "fax_number": "309-589-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARMIENTO",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036070719",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036-070719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.