Jacob Alexander Reshetar, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

74729 Issued in AZ

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(309) 655-2000

NPI assigned

Apr 11, 2022

Sex

Male

Sole proprietor

No

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.

• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433

  AZ, Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674

  AZ

  Medicare reassignment

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

• VHS of Arrowhead, Inc

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1326022765

  Hospital

  Care Compare affiliation
• VHS of Arrowhead, Inc.

  • General Acute Care Hospital
  • Peoria, AZ
  • NPI 1801340781

  Hospital

  Care Compare affiliation
• VHS of Phoenix Inc

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1477537363

  Hospital

  Care Compare affiliation

Specialty

Emergency Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Group of Arizona Professional Corporation 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Abrazo Arrowhead Hospital Hospital, Glendale, AZ, CCN 030094
• Abrazo Central Campus Hospital, Phoenix, AZ, CCN 030030

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2026.

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1780326652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESHETAR",
        "first_name": "JACOB",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "74729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Renfroe, M.D.
• Olivia Renken
• Amanda Repplinger, APN
• Carlos Andres Requena Armas, M.D.
• Alyssa Rescinito
• Residential Alternatives of Illinois, Inc.
• Resource Management Services, Inc
• Resource Management Services, Inc.
• Respiratory Unit Dose Pharmacy Inc.
• Retina Consultants of Central Illinois, SC

• All providers in Peoria, IL
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.