NPIMap

Individual provider Active NPI

Kevin J Peifer, M.D.

  • Gastroenterology Physician
  • Rockford, IL
National Provider Identifier
1699751446
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
36114937 Issued in IL
Practice address
401 Roxbury Rd
Rockford, IL 61107-5075
Phone
(815) 397-7340
Fax
(815) 397-2156
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 36114937 IL Primary

Addresses

Primary practice location

401 Roxbury Rd
Rockford, IL 61107-5075

Mailing address

401 Roxbury Rd
Rockford, IL 61107-5075
Phone (815) 397-7340

Other identifiers 2

IdentifierTypeStateIssuer
2001008546OtherMOMO PHYSICIAN LICENSE
36114937OtherILIL PHYSICIAN LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060605000041 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 7315983905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Medical College of Ohio, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

401 Roxbury Rd
Rockford, IL 61107-5075
Phone (815) 397-7340

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.6 of 100Reported as group
Quality
66.79
Promoting interoperability
63
Improvement activities
40
Cost
76.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy68
Upper gastrointestinal (GI) endoscopy for acid reflux194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36114937ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Gastroenterology Associates, LTD. Gastroenterology CurrentSince Jul 1, 2006 Accepting new patients
Rockford Gastroenterology Associates, LTD. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince May 1, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

401 Roxbury Rd
Rockford, IL 61107
Phone (815) 397-7340

Interoperability endpoints

  • Direct secure messaging: kevin.peifer.p1@direct.rga.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1699751446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075075",
            "telephone_number": "815-397-7340",
            "fax_number": "815-397-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075075",
            "telephone_number": "815-397-7340",
            "fax_number": "815-397-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEIFER",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "36114937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO PHYSICIAN LICENSE",
            "identifier": "2001008546",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL PHYSICIAN LICENSE",
            "identifier": "36114937",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.