Individual provider Active NPI

Stephen R Orlevitch, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Peoria, IL
National Provider Identifier
1841290913
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
36101037 Issued in IL
Practice address
303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone
(309) 676-5546
Fax
(309) 676-5045
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 36101037 IL Primary

Addresses

Primary practice location

303 N William Kumpf Blvd
Peoria, IL 61605-2507

Mailing address

303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone (309) 676-5546

Other identifiers 1

IdentifierTypeStateIssuer
36101037MedicaidIL

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
I20100225000504 IL Practitioner - Orthopedic Surgery 1456411693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1993
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)

3422 A Court St
Pekin, IL 61554-6235
Phone (309) 477-6000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036104565ILMDSports Medicine (Orthopaedic Surgery) Physician
36101037ILMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jul 17, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Musculoskeletal Surgery Center, LLC PastSince Jul 1, 2009 Accepting new patients

Locations

3422 Court St
#A
Pekin, IL 61554
Phone (309) 477-6000

8600 State Route 91
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

303 N William Kumpf Blvd
Peoria, IL 61605
Phone (309) 676-5546

8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000

Organizations & group practices 3

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 1

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1841290913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546",
            "fax_number": "309-676-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546",
            "fax_number": "309-676-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORLEVITCH",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "36101037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36101037",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.