NPIMap

Individual provider Active NPI

Deepak Taneja, M.D.

  • Hospitalist Physician
  • Peoria, IL
National Provider Identifier
1841492394
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2007028030 Issued in MO
Practice address
1001 Main St
Suite 200
Peoria, IL 61606-1907
Phone
(309) 672-5682
Fax
(309) 672-3147
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2007028030 MO Primary
Hospitalist Physician 208M00000X 04-33300 KS
Internal Medicine Physician 207R00000X 2007028030 MO
Internal Medicine Physician 207R00000X 04-33300 KS

Addresses

Primary practice location

1001 Main St
Suite 200
Peoria, IL 61606-1907

Mailing address

1001 Main St Ste 200
Suite 200
Peoria, IL 61606-2035
Phone (309) 672-5682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121206000544 IL Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3779679766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
Osf Healthcare SystemGroup PAC ID 4284541806, 94 clinicians
Kewanee HospitalGroup PAC ID 4789578063, 26 clinicians

Practice addresses (Care Compare)

1001 Main St
Suite 200
Peoria, IL 61606-2035
Phone (309) 672-5682

1051 W S St
Kewanee, IL 61443-8354
Phone (309) 852-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-33300KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System Current Accepting new patients
Osf Healthcare System CurrentSince Dec 1, 2015 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System CurrentSince Dec 1, 2015 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Scenic Drive Inpatient Services LLC Hospitalist Past Accepting new patients
Saint Lukes Physician Group II LLC Hospitalist Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1505 Eastland Dr
Ste 1100
Bloomington, IL 61701
Phone (309) 663-2100

801 Fox Run
Heyworth, IL 61745
Phone (309) 473-2069

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

1001 Main St
Ste 200
Peoria, IL 61606
Phone (309) 308-2010

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

Organizations & group practices 8

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 4

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1841492394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE 200",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062035",
            "telephone_number": "309-672-5682",
            "fax_number": "309-672-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061907",
            "telephone_number": "309-672-5682",
            "fax_number": "309-672-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANEJA",
        "first_name": "DEEPAK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2007028030",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "04-33300",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007028030",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-33300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.