Individual provider Active NPI

Debra Lynn Pyszka

  • Physician Assistant
  • Peru, IL
National Provider Identifier
1720161524
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
920 West St
Suite 211
Peru, IL 61354-2763
Phone
(815) 223-2143
NPI assigned
Oct 23, 2006
Last updated
Aug 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

920 West St
Suite 211
Peru, IL 61354-2763

Mailing address

1305 6TH St
Peru, IL 61354-2759
Phone (815) 780-4644

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041201000435 IL Practitioner - Physician Assistant 0648235689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 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)

1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100

1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 227-5600

1614 E Norris Dr
OBGYN and Anti Coag
Ottawa, IL 61350-3681
Phone (815) 431-0435

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

920 W St
Suite 218 Ortho
Peru, IL 61354-2769
Phone (815) 431-5746

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Constantino Perales Jr., M.D. Past Accepting new patients
Cardinal Medical Group, LTD. Past Accepting new patients

Locations

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

Organizations & group practices 5

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 4

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1720161524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 6TH ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542759",
            "telephone_number": "815-780-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEST ST",
            "address_2": "SUITE 211",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542763",
            "telephone_number": "815-223-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYSZKA",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

Verify at the official NPI Registry.