AMANDA BUCK (DO) – Obstetrics & Gynecology Physician, NPI 1104481332

AMANDA BUCK (DO) is a healthcare provider. based in Peoria, Illinois. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials DO. They hold a License No. 036.165432 (IL). The NPI Number for AMANDA BUCK (DO) is 1104481332

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA BUCK (DO)
NPI
1104481332
Phone
Not provided
Address
530 NE GLEN OAK AVE
Enumeration Date
2 May 2019
Last Update Date
27 July 2023

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
3126663494
Graduation Year
2019 (7 years ago)
PAC ID
8123356987
Group Practice PAC ID
9537050422
Professional Enrollment ID
I20231018000226
Address ID
IL606225646CH1701XSTXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,925 OBSTETRICS/GYNECOLOGY in IL

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Provider Addresses for AMANDA BUCK (DO)

  • Saint Francis Medical Center, 530, Northeast Glen Oak Avenue, Peoria, Peoria County, Illinois, 61637, United States

    PEORIA, IL 616370001

    Phone:

    Type: Mailing

  • 5215 N CALIFORNIA AVE FL 7

    CHICAGO, IL 606257014

    Phone: (312) 666-3494

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231018000226IObstetrics/GynecologyILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61637)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537050422View full group profile
NameSpecialtyState
Family PracticeIL
Family Practice, Osteopathic Manipulative MedicineIL
Nurse PractitionerIL
-IL
Clinical Social WorkerIL
-IL
O B S T E T R I C S/ G Y N E C O L O G YOH
Family PracticeKS
Nurse PractitionerIL
P S Y C H I A T R YNY

Reviews

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Frequently asked questions

Does AMANDA BUCK (DO) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — AMANDA BUCK (DO) uses 1104481332.
Is AMANDA BUCK (DO) listed as active for patients and plans?
The listing shows AMANDA BUCK (DO) as active in the NPI system.
What taxonomy line describes AMANDA BUCK (DO)?
For research purposes, treat AMANDA BUCK (DO) as Obstetrics & Gynecology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for AMANDA BUCK (DO)?
AMANDA BUCK (DO)'s geographic hint is Peoria, Illinois in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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