Amanda Gawelek, NP-FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209013391 Issued in IL

Practice address

5001 N University St
Peoria, IL 61614-4799

Phone

(309) 693-2225

Fax

(309) 693-2228

NPI assigned

Oct 20, 2015

Last updated

Jan 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda Bare Former name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Peoria Physical Medicine and RehabGroup PAC ID 5294795472, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Greater Peoria Physical Medicine & Rehab

  dba Joseph & Hishon Chiropractic

  • Chiropractor
  • Peoria, IL
  • NPI 1861618829

  Family

  Medicare reassignment Care Compare group NPD
• Greater Peoria Physical Medicine

  • Massage Therapist
  • Peoria, IL
  • NPI 1699152488
  NPD (past)

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1912379777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144799",
            "telephone_number": "309-693-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144799",
            "telephone_number": "309-693-2225",
            "fax_number": "309-693-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWELEK",
        "first_name": "AMANDA",
        "credential": "NP-FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209013391",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BARE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Gauerke, LSW
• Aasna Gaur, DO
• Katherine Gavin, ATC
• Thecla A Gavin, MAC, NCC, LPC
• Micaela Gaviola
• Nasser Mikhail Gayed, M.D.
• Love Gaytan Cintora
• Maureen A Gebhards
• William Gebhards
• Eunice Rebekah Geevarghese

• Family Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.