Active NPI
Lisa E. Snyder, MD
- Physical Medicine & Rehabilitation Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 036-073903
- Practice address
- 6501 N Sheridan Rd
Peoria, IL 61614-2932 - Phone
- (309) 692-8110
- Fax
- (309) 692-8673
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 036-073903 | IL | Primary |
Addresses
Primary practice location
6501 N Sheridan Rd
Peoria, IL 61614-2932
Mailing address
6501 N Sheridan Rd
Peoria, IL 61614-2932
Phone (309) 692-8110
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009033 | Other | IL | HEALTH ALLIANCE PROVIDER |
| 036073903 | Medicaid | IL | |
| 250004431 | Other | IL | RAIL ROAD MEDICARE ID |
| 370681567-02 | Other | IL | JOHN DEERE PROVIDER NUMBE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Advanced Physical Therapy Services, LTD.
Practice addresses (Care Compare)
200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone (309) 624-4000
61 E Side SQ
Canton, IL 61520-2603
Phone (309) 649-1572
Hospital & facility affiliations
- Saint Francis Medical Center
- Osf Saint Clare Medical Center
- Osf Saint Elizabeth MDL Ctr
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-073903 | IL | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Healthcare System | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Healthcare System | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Osf Healthcare System | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
180 S Main St
Canton, IL 61520
Phone (309) 647-5240
1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141
3422 Court St
#A
Pekin, IL 61554
Phone (309) 477-6000
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
6501 N Sheridan Rd
Peoria, IL 61614
Phone (309) 692-8110
200 E Pennsylvania Ave
Peoria, IL 61603
Phone (309) 624-4000
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Certified Registered Nurse Anesthetist
- Monmouth, IL
- NPI 1811016124
-
- Rural Health Clinic/Center
- Kewanee, IL
- NPI 1427475177
-
- General Acute Care Hospital
- Dixon, IL
- NPI 1508683590
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Princeton, IL
- NPI 1093308439
-
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276560000000",
"number": "1790715092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6501 N SHERIDAN RD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142932",
"telephone_number": "309-692-8110",
"fax_number": "309-692-8673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 N SHERIDAN RD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142932",
"telephone_number": "309-692-8110",
"fax_number": "309-692-8673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "LISA",
"middle_name": "E.",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2010-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "IL",
"license": "036-073903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE PROVIDER",
"identifier": "009033",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036073903",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE ID",
"identifier": "250004431",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE PROVIDER NUMBE",
"identifier": "370681567-02",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.