Individual provider Active NPI

Jacob Tony, M.D.

  • Neurology Physician
  • Peoria, IL
National Provider Identifier
1881815488
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
125-046927 Issued in IL
Practice address
900 Main St Ste 250
Peoria, IL 61602-5006
Phone
(309) 672-4522
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 125-046927 IL Primary

Addresses

Primary practice location

900 Main St Ste 250
Peoria, IL 61602-5006

Mailing address

900 Main St Ste 250
Peoria, IL 61602-5006
Phone (309) 672-4522

Other identifiers 1

IdentifierTypeStateIssuer
036119046OtherILLICENSE

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
I20081025000101 IL Practitioner - Neurology 9830257484 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak
Peoria, IL 61636-0001
Phone (309) 672-5522

221 NE Glen Oak Ave
Peoria, IL 61636-0001

600 S 13TH St
Pekin, IL 61554-4936

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

900 Main St
Suite 250
Peoria, IL 61602-5006
Phone (309) 672-4522

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-046927ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems CurrentSince Feb 1, 2015 Accepting new patients
Proctor Health Systems CurrentSince Feb 1, 2015 Accepting new patients
Pekin Prohealth Inc Neurology CurrentSince Jan 6, 2018 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
Proctor Health Systems Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Oct 3, 2017 Accepting new patients

Locations

1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

900 Main St
Ste 250
Peoria, IL 61602

815 Main St
Ste A1
Peoria, IL 61602

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: jtonymd388550@carlehiedirect.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 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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1881815488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025006",
            "telephone_number": "309-672-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025006",
            "telephone_number": "309-672-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONY",
        "first_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125-046927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036119046",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.