Individual provider Active NPI

Cristy Lee Tomaszewski, LCSW

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1679112429
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-019899 Issued in IL
Practice address
711 W John Gwynn Ave
Peoria, IL 61605-2270
Phone
(309) 680-7600
Fax
(309) 671-2188
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-019899 IL Primary

Addresses

Primary practice location

711 W John Gwynn Ave
Peoria, IL 61605-2270

Mailing address

2214 N University St
Peoria, IL 61604-3221
Phone (309) 680-7669

Other practice location 1

19 Olt Ave
Pekin, IL 61554-6214
Phone (309) 680-7600

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821000942 IL Practitioner - Clinical Social Worker 0042647752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Mental Health SCGroup PAC ID 8921074485, 8 clinicians

Practice addresses (Care Compare)

900 Main St
Suite 580
Peoria, IL 61602-1065
Phone (309) 637-4266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-019899ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Mental Health, SC Clinical CurrentSince May 26, 2024 Accepting new patients

Locations

900 Main St
Ste 580
Peoria, IL 61602
Phone (309) 637-4266

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1679112429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043221",
            "telephone_number": "309-680-7669",
            "fax_number": "309-681-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W JOHN GWYNN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052270",
            "telephone_number": "309-680-7600",
            "fax_number": "309-671-2188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Olt Ave",
            "address_purpose": "LOCATION",
            "city": "Pekin",
            "state": "IL",
            "postal_code": "615546214",
            "country_code": "US",
            "telephone_number": "309-680-7600",
            "fax_number": "309-353-3334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMASZEWSKI",
        "first_name": "CRISTY",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-019899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.