DR. WORLALI MOSES NUTAKOR (M.D.) – Emergency Medicine Physician, NPI 1104937960

DR. WORLALI MOSES NUTAKOR (M.D.) is a healthcare provider. based in Forsyth, Illinois. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 036103408 (IL). The NPI Number for DR. WORLALI MOSES NUTAKOR (M.D.) is 1104937960

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. WORLALI MOSES NUTAKOR (M.D.)
NPI
1104937960
Phone
(217) 872-6134
Address
775 SPYGLASS BLVD
Enumeration Date
31 August 2006
Last Update Date
4 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2174642966
Graduation Year
1992 (34 years ago)
PAC ID
8123925740
Group Practice PAC ID
3274793633
Professional Enrollment ID
I20031212000694
Address ID
IL625213810DE1800XDRXX500

Contacts

Secure Messaging
wnutakor168051@ewd.direct.hshs.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,845 EMERGENCY MEDICINE in IL

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Provider Addresses for DR. WORLALI MOSES NUTAKOR (M.D.)

  • 775 SPYGLASS BLVD

    FORSYTH, IL 625359639

    Phone: (217) 872-6134

    Type: Mailing

  • Decatur Correctional Center, 2310, East Mound Road, Decatur, Macon County, Illinois, 62526, United States

    DECATUR, IL 625269640

    Phone: (217) 877-0353

    Type: Location

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: 2003-12-12

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
I20031212000694IEmergency MedicineILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making269257$0
99284Emergency department visit with moderate level of medical decision making8279$0
99291Critical care, first 30-74 minutes8281$0
View full utilization report →

Insurance plans in this area (ZIP 62535)

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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: 3274793633View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Emergency Medicine, Internal MedicineIN
-IL
Emergency MedicineWI
Emergency MedicineIL
Emergency MedicinePA
Emergency MedicineCA
Emergency MedicineIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Where can patients find DR. WORLALI MOSES NUTAKOR (M.D.)'s NPI?
You can confirm DR. WORLALI MOSES NUTAKOR (M.D.) with NPI 1104937960; it appears in the national provider directory.
Does this profile mean DR. WORLALI MOSES NUTAKOR (M.D.) is currently active?
Yes — DR. WORLALI MOSES NUTAKOR (M.D.) appears active in the national provider directory.
Does DR. WORLALI MOSES NUTAKOR (M.D.) list a primary specialty?
If you are matching referrals, note Emergency Medicine Physician for DR. WORLALI MOSES NUTAKOR (M.D.). Clinical services aligned with this taxonomy classification.
What location shows for DR. WORLALI MOSES NUTAKOR (M.D.)?
We surface Forsyth, Illinois for DR. WORLALI MOSES NUTAKOR (M.D.) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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