Individual provider Active NPI

Froilan V Perucho, APN

  • Family Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1871286393
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.027551 Issued in IL
Practice address
3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401
Phone
(217) 862-0800
Fax
(217) 862-0202
NPI assigned
May 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.027551 IL Primary

Addresses

Primary practice location

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401

Mailing address

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401
Phone (217) 862-0800

Other identifiers 1

IdentifierTypeStateIssuer
041.300011OtherILRN LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809002073 IL Practitioner - Nurse Practitioner 1254793169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

3132 Old Jacksonville Rd
Suite 200
Springfield, IL 62704-7401
Phone (217) 862-0800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.027551ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services CurrentSince Jul 24, 2023 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Memorial Physician Services CurrentSince Jul 24, 2023 Accepting new patients
Memorial Physician Services Current Accepting new patients
Memorial Expresscare, LLC Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

3132 Old Jacksonville Rd
Ste 200
Springfield, IL 62704
Phone (217) 862-0800

Interoperability endpoints

  • Direct secure messaging: froilanperucho@sfc.allscriptsdirect.net

Organizations & group practices 7

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 3

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1871286393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUCHO",
        "first_name": "FROILAN",
        "middle_name": "V",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041.300011",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.