Individual provider Active NPI

Elissa Roop

  • Family Nurse Practitioner
  • East Peoria, IL
National Provider Identifier
1912850579
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209035042 Issued in IL
Practice address
133 Spinder Dr
East Peoria, IL 61611-0016
Phone
(855) 673-4325
Fax
(855) 673-4325
NPI assigned
Feb 16, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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 209035042 IL Primary

Addresses

Primary practice location

133 Spinder Dr
East Peoria, IL 61611-0016

Mailing address

133 Spinder Dr
East Peoria, IL 61611-0016
Phone (855) 673-4325

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
I20260407000909 IL Practitioner - Nurse Practitioner 3476028580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

3626 N Sheridan Rd
Peoria, IL 61604-1401
Phone (309) 308-5100

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-8156

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209035042ILMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1912850579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SPINDER DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616110016",
            "telephone_number": "855-673-4325",
            "fax_number": "855-673-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SPINDER DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616110016",
            "telephone_number": "855-673-4325",
            "fax_number": "855-673-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOP",
        "first_name": "ELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209035042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

Verify at the official NPI Registry.