Individual provider Active NPI

Abraham Ramy Frenkel, MD

  • Psychiatry Physician
  • Peoria, IL
National Provider Identifier
1861584542
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036101542 Issued in IL
Practice address
7317 N Willow Lake CT
Peoria, IL 61614-8260
Phone
(309) 683-7373
Fax
(309) 691-4408
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036101542 IL Primary

Addresses

Primary practice location

7317 N Willow Lake CT
Peoria, IL 61614-8260

Mailing address

7317 N Willow Lake CT
Peoria, IL 61614-8260
Phone (309) 683-7373

Other identifiers 4

IdentifierTypeStateIssuer
CA4079OtherRR GROUP #
036101542MedicaidIL
809840OtherMEDICARE GROUP #
P00424276OtherRR INDIVIDUAL #

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
I20040326001238 IL Practitioner - Psychiatry 7315839099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1978
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

Practice addresses (Care Compare)

7317 N Willow Lake CT
Psychiatry Psychol
Peoria, IL 61614-8227
Phone (309) 683-7373

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

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

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

7317 N Willow Lake Ct
Peoria, IL 61614
Phone (309) 683-7373

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1861584542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7317 N WILLOW LAKE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148260",
            "telephone_number": "309-683-7373",
            "fax_number": "309-691-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7317 N WILLOW LAKE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148260",
            "telephone_number": "309-683-7373",
            "fax_number": "309-691-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRENKEL",
        "first_name": "ABRAHAM",
        "middle_name": "RAMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036101542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP #",
            "identifier": "CA4079",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101542",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "809840",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR INDIVIDUAL #",
            "identifier": "P00424276",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.