Nicholas John Peacock, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036142666 Issued in IL

Practice address

520 S Maple Ave
Oak Park, IL 60304-1022

Phone

(708) 660-5995

Fax

(708) 660-2251

NPI assigned

Jun 17, 2013

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Rush Oak Park ER Physicians GroupGroup PAC ID 8820190606, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npeacock137874@direct.rush.rush-health.com

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.

• Rush Oak Park ER Physicians Group

  • Emergency Medical Services (Emergency Medicine) Physician
  • Oak Park, IL
  • NPI 1447260880
  Medicare reassignment Care Compare group NPD
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Emergency Medicine

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rush Oak Park Hospital Inc

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1558391706
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619316304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S MAPLE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041022",
            "telephone_number": "708-660-5995",
            "fax_number": "708-660-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S MAPLE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041022",
            "telephone_number": "708-660-5995",
            "fax_number": "708-660-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036142666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PCC Community Wellness Center (PCC Dr. Tong Health Center)
• PCC Community Wellness Center
• PCC Community Wellness Center
• Peace Plus Power
• Munirih Peace, MS, RDN, LDN
• Peak Behavioral Health (Autism Care Therapy)
• Peak Behavioral Services (Autism Care Therapy)
• Lisa Pearah
• Walter A Pedemonte, M.D.
• Jenna Pederson

• Emergency Medicine Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.