Nicholas Ryan Petre, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125.072248 Issued in IL

Practice address

306 46TH Ave
East Moline, IL 61244-4281

Phone

(309) 796-2329

Fax

(309) 796-1146

NPI assigned

Jun 15, 2018

Sex

Male

Sole proprietor

No

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

Family Practice

Education

Southern Illinois University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stone Ridge Medical Group SCGroup PAC ID 8729142534, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CAIFAA
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Stone Ridge Medical Group SC

  • Family Medicine Physician
  • East Moline, IL
  • NPI 1306097894
  Medicare reassignment Care Compare group NPD
• Milan Medical Group LTD

  dba Blackwood Family Wellness

  • General Practice Physician
  • Milan, IL
  • NPI 1346362589
  Medicare reassignment NPD
• Eon Care Clinicians PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1073332490
  NPD (past)

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

• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Trinity Medical Center

  dba Trinity Rock Island

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1699269308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 46TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612444281",
            "telephone_number": "309-796-2329",
            "fax_number": "309-796-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 46TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612444281",
            "telephone_number": "309-796-2329",
            "fax_number": "309-796-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRE",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.072248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna K Pepping
• Lauren Peterson
• Kathy M Petosky, RD
• Anne M Petre, MD
• James E Petre, MD
• Shelagh Phillips, PHARM.D.
• Steven Robert Pletscher, DDS
• Erica Preslar
• Berlin Pruden
• Quad Cities Family Chiropractic L.L.C.

• Family Medicine Physician in East Moline, IL
• Providers in East Moline, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.