Individual provider Active NPI

Maryelizabeth Tyler James, M.D.

  • Surgery Physician
  • Peoria, IL
National Provider Identifier
1689817371
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036128794 Issued in IL
Practice address
303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone
(309) 676-5546
Fax
(309) 676-5045
NPI assigned
Apr 11, 2009
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036128794 IL
Surgery Physician 208600000X 036128794 IL Primary
Surgery of the Hand (Surgery) Physician 2086S0105X 036128794 IL

Addresses

Primary practice location

303 N William Kumpf Blvd
Peoria, IL 61605-2507

Mailing address

303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone (309) 676-5546

Other names 1

  • Dr. Maryelizabeth Tyler Rashid Former name

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
I20111026000881 IL Practitioner - Orthopedic Surgery 8224154323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Healthcare SystemGroup PAC ID 4284541806, 94 clinicians
Kewanee HospitalGroup PAC ID 4789578063, 26 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

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

7800 N Sommer St
Peoria, IL 61615-1934
Phone (309) 676-5546

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
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036128794ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System CurrentSince Oct 1, 2016 Accepting new patients
Osf Healthcare System CurrentSince Oct 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 17, 2016 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

303 N William Kumpf Blvd
Peoria, IL 61605
Phone (309) 676-5546

8600 State Route 91
Peoria, IL 61615
Phone (309) 624-3250

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

8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000

Organizations & group practices 6

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 1

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": "1239408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1689817371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546",
            "fax_number": "309-676-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546",
            "fax_number": "309-676-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "MARYELIZABETH",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-11",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036128794",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036128794",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036128794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYELIZABETH",
            "last_name": "RASHID",
            "middle_name": "TYLER",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.