Individual provider Active NPI

Hematheja Lanka, DO

  • Family Medicine Physician
  • Pontiac, IL
National Provider Identifier
1750801619
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036154165 Issued in IL
Practice address
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone
(815) 842-2828
Fax
(815) 842-4912
NPI assigned
Jun 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036154165 IL Primary

Addresses

Primary practice location

2500 W Reynolds St
Pontiac, IL 61764-9774

Mailing address

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

Other practice location 1

9 Hospital Park
Moultrie, GA 31768-6772
Phone (229) 985-3003

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
I20201008001687 IL Practitioner - Family Practice 2365862562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia Col of Osteo Med, Sewanee, 2017
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)

2500 W Reynolds St
Suite 203
Pontiac, IL 61764-9774
Phone (815) 844-5115

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Sep 29, 2020 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

2500 W Reynolds St
#203
Pontiac, IL 61764
Phone (815) 844-5115

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

Organizations & group practices 2

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 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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1750801619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-842-2828",
            "fax_number": "815-842-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-842-2828",
            "fax_number": "815-842-4912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Hospital Park",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686772",
            "country_code": "US",
            "telephone_number": "229-985-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANKA",
        "first_name": "HEMATHEJA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036154165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, IL

Sources for this page

Verify at the official NPI Registry.