Peter Baumgartel, MD
Individual provider Active NPI Nuclear Radiology Physician · Peoria, IL
NPI 1932276672 · NPPES record last updated Dec 6, 2023
Key facts
- NPI
- 1932276672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nuclear Radiology Physician 2085N0904X
- License
- 036079988 (IL)
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-5264 - Phone
- (309) 655-2000
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Northeastern Ohio University College of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Central Illinois Radiological Associates LTD
Cira Michigan PC
Osf Multi-Specialty Group
Practice addresses (Care Compare)
1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-1400
1051 W S St
Kewanee, IL 61443-8354
Phone (309) 852-7500
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100
111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311
1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 539-7461
1505 Eastland Dr
Bloomington, IL 61701-3636
Phone (309) 663-2100
2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828
2800 W 95TH St
Evergreen, IL 60805-2701
Phone (309) 740-4272
3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000
3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161
435 Maxine Dr
Morton, IL 61550-2498
Phone (309) 263-2424
4914 N Weaverridge Blvd
Peoria, IL 61615-8910
Phone (906) 786-5707
5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-2428
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272
530 Neglen Oak Ave
Peoria, IL 61636-0001
Phone (309) 655-2000
530 Park Ave E
Perry Memorial Hosp
Princeton, IL 61356-3901
Phone (815) 875-2811
812 N Logan Ave
Danville, IL 61832-3752
Phone (217) 443-5000
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
925 W St
Peru, IL 61354-2757
Phone (815) 221-1380
Hospital & facility affiliations
- Saint Francis Medical Center
- St Mary Medical Center
- Saint James Hospital
- Osf Sacred Heart Medical Center
- St Joseph Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090331000497 | IL | Practitioner - Diagnostic Radiology | 9537226865 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301501049 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current |
Accepting new patients |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Cira Michigan PC | Diagnostic Radiology | Current |
Accepting new patients |
| Central Illinois Neuroradiology, LTD | Past | Accepting new patients | |
| Global Medical Imaging, SC | Diagnostic Radiology | Past | Accepting new patients |
| Northeast Radiology Associates, S.C. | Past | Accepting new patients |
Locations
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054
111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
114 W Stratford Dr
Ste E
Peoria, IL 61614
Phone (309) 740-4270
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Radiology Physician | 2085N0904X | 4301501049 | MI | |
| Diagnostic Radiology Physician | 2085R0202X | 036079988 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 4301501049 | MI | |
| Nuclear Radiology Physician | 2085N0904X | 036079988 | IL | Yes |
Addresses
Primary practice location
530 NE Glen Oak Ave
Peoria, IL 61637-5264
Mailing address
111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272
Other practice location 1
1800 Hollister Dr
Suite G-18
Libertyville, IL 60048-5264
Phone (847) 918-1462
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4923631 | Other | IL | BCBS ID |
| 202926 | Other | IL | GROUP PTAN |
| 212545 | Other | IL | GROUP PTAN |
| 036079988 | Medicaid | IL |
Other providers in Peoria, IL
- Elizabeth A Bauer-Marsh
- James W Bauer
- Robert Bauernfeind
- Rebecca Lynn Baumann
- Gavin Jude Baumgart
- Thanasis Christos Bavelis
- Mariam Bawany
- Michelle C Bayer
- Debra E Beach
- Julia Ann Beal
All providers in Peoria, IL · Nuclear Radiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.