Donald E Penn Jr., M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036062844 Issued in IL

Practice address

1001 Main St
Suite 500a
Peoria, IL 61606

Phone

(309) 672-4980

Fax

(309) 671-2944

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
• Carle Eureka Hospital Hospital, Eureka, IL, CCN 141309
• Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
• Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpennmd323017@carlehiedirect.net

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment Care Compare group NPD
• Carle Eureka Hospital

  • Critical Access Hospital
  • Eureka, IL
  • NPI 1184644023
  Medicare reassignment NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Illinois Gastroenterology Group, LLC

  • Gastroenterology Physician
  • Elgin, IL
  • NPI 1316277817
  Medicare reassignment NPD
• Pekin Prohealth Inc

  • Family Medicine Physician
  • Pekin, IL
  • NPI 1932150299
  Medicare reassignment NPD
• Elgin Gastroenterology Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Elgin, IL
  • NPI 1992875454
  NPD
• Elgin Gastroenterology SC

  • Gastroenterology Physician
  • Elgin, IL
  • NPI 1932291101
  NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Methodist Medical Center of Illinois

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  NPD
• Northwest Gastroenterologists SC

  • Specialist
  • Arlington Heights, IL
  • NPI 1801886221
  NPD
• Central Illinois Orthopedic Surgery II LLC.

  • Orthopaedic Surgery Physician
  • Bloomington, IL
  • NPI 1508889965
  NPD (past)

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

• Carle Eureka Hospital

  • Critical Access Hospital
  • Eureka, IL
  • NPI 1184644023
  Care Compare affiliation
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation
• Pekin Memorial Hospital

  • General Acute Care Hospital
  • Pekin, IL
  • NPI 1245227479
  Care Compare affiliation
• Proctor Community Hospital

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1033116876
  Care Compare affiliation
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243555200000",
    "number": "1780628388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615500365",
            "telephone_number": "309-672-4980",
            "fax_number": "309-671-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "SUITE 500A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61606",
            "telephone_number": "309-672-4980",
            "fax_number": "309-671-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "DONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036062844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX IDENTIFICATIO",
            "identifier": "371221637",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "07215152",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "166330",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100004399",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0101",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH PLANS",
            "identifier": "4282553",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "008850",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062844",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "776530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Peifer
• Michael Leroy Peil, M.D.
• Mary Ness Pelayo
• Jose Manuel Pena, MD
• Alison Emily Pendergast, LCPC
• Peoria Area Vision Care, LLC
• Peoria Area Women'S Hospitalist
• Peoria Association for Retarded Citizens Inc
• Peoria Association for Retarded Citizens Inc
• Peoria Association for Retarded Citizens Inc

• Gastroenterology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; 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.