NPIMap

Organization Active NPI

Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
National Provider Identifier
1982656575
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
0001594 Issued in IL
Legal business name
METHODIST MEDICAL CENTER OF ILLINOIS
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone
(309) 672-4813
NPI assigned
May 16, 2006
Last updated
Feb 14, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST MEDICAL CENTER OF ILLINOISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Authorized official

Name
Stephen Cirone
Title
Regional MGR-Reimb/Rev Recognition
Phone
(309) 672-4813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 0001594 IL Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000494 IL Part B Supplier - Clinic/Group Practice 1355259714 Receives reassigned benefits from 751 practitioners
3 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Methodist Medical Center Il

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 760

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 760

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1982656575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "CIRONE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "REGIONAL MGR-REIMB/REV RECOGNITION",
        "authorized_official_telephone_number": "309-672-4813"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IL",
            "license": "0001594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.