Individual provider Active NPI

Joseph P Croegaert, MSW, LCSW

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1770663908
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3020 W Willow Knolls Dr
Peoria, IL 61614-8127
Phone
(309) 681-5850
Fax
(309) 681-5658
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

3020 W Willow Knolls Dr
Peoria, IL 61614-8127

Mailing address

3020 W Willow Knolls Dr
Peoria, IL 61614-8127
Phone (309) 681-5850

Other identifiers 2

IdentifierTypeStateIssuer
113255OtherILHEALTH ALLIANCE ID
IL0119 FOR 371337853OtherILID FOR JOHN DEERE HEALTH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051222000688 IL Practitioner - Clinical Social Worker 8921020595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Resource Management Services IncGroup PAC ID 6305822842, 2 clinicians

Practice addresses (Care Compare)

3020 W Willow Knolls Dr
Suite 2
Peoria, IL 61614-8129
Phone (309) 681-5652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.007052ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Management Services, Inc. Clinical CurrentSince Mar 3, 2010 Accepting new patients

Locations

3020 W Willow Knolls Dr
Ste 2
Peoria, IL 61614
Phone (309) 681-5652

3020 W Willow Knolls Dr
Ste B
Peoria, IL 61614
Phone (309) 681-5850

3020 W Willow Knolls Dr
Peoria, IL 61614
Phone (309) 681-5652

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770663908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148127",
            "telephone_number": "309-681-5850",
            "fax_number": "309-681-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148127",
            "telephone_number": "309-681-5850",
            "fax_number": "309-681-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROEGAERT",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE ID",
            "identifier": "113255",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID FOR JOHN DEERE HEALTH",
            "identifier": "IL0119 FOR 371337853",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.