NPIMap

Individual provider Active NPI

Giovanni Colombo, M.D.

  • Urology Physician
  • Peoria, IL
National Provider Identifier
1679537831
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036084610 Issued in IL
Practice address
7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone
(309) 692-9898
Fax
(309) 692-9055
NPI assigned
Apr 14, 2006
Last updated
Oct 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036084610 IL Primary

Addresses

Primary practice location

7309 N Knoxville Ave
Peoria, IL 61614-2085

Mailing address

7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone (309) 692-9898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050129000062 IL Practitioner - Urology 6901856707 Reassigns benefits to 2 organizations
I20220112000578 SC Practitioner - Urology 6901856707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Loyola University of Chicago, Stritch School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

135 Professional Park Dr
Seneca, SC 29678-2558
Phone (864) 882-8074

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036084610ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 16, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 25, 2019 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 16, 2022 Accepting new patients
Midwest Urological Group, LTD. Current Accepting new patients
Pekin Prohealth Inc Urology CurrentSince Jun 5, 2017 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 25, 2019 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1503 Valle Vista Blvd
Pekin, IL 61554
Phone (309) 353-1822

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

135 Professional Park Dr
Seneca, SC 29678
Phone (864) 882-5306

Interoperability endpoints

  • Direct secure messaging: gcolombo542736@direct.ghs.myhfn.org
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.105053

Organizations & group practices 7

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 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1679537831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "309-692-9898",
            "fax_number": "309-692-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "309-692-9898",
            "fax_number": "309-692-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMBO",
        "first_name": "GIOVANNI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036084610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.