Active NPI
Tayyaba Irshad, M.D.
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician
- License
- 036128654
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (309) 624-8829
- NPI assigned
- May 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 41219 | KY | |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 036128654 | 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) 624-8829
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120418000675 | IL | Practitioner - Hospice/Palliative Care | 5890790430 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Hospice/Palliative Care
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (877) 464-6640
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41219 | KY | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients |
Locations
2200 Fort Jesse Rd
Normal, IL 61761
Phone (309) 268-9300
719 N William Kumpf Blvd
Ste 100
Peoria, IL 61605
Phone (309) 624-9934
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
530 Neglen Oak Ave
Peoria, IL 61637
Phone (877) 464-6640
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1629035829",
"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": "309-624-8829"
},
{
"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": "309-624-8829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRSHAD",
"first_name": "TAYYABA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "KY",
"license": "41219",
"primary": false
},
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "IL",
"license": "036128654",
"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 Oct 21, 2019; 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.