TARA FLEEMAN – Psychiatric/Mental Health Nurse Practitioner, NPI 1124838065

TARA FLEEMAN is a healthcare provider. based in Salem, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209032543 (IL). The NPI Number for TARA FLEEMAN is 1124838065

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
TARA FLEEMAN
NPI
1124838065
Phone
(618) 548-3194
Address
1201 RICKER RD
Enumeration Date
13 January 2025
Last Update Date
14 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6182834229
Graduation Year
2025 (1 year ago)
PAC ID
6204332760
Group Practice PAC ID
8224050638
Professional Enrollment ID
I20251002004336
Address ID
IL624712214VA421XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:1State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for TARA FLEEMAN

  • 1201 RICKER RD

    SALEM, IL 628814263

    Phone: (618) 548-3194

    Mailing address matches the actual address.

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: 2025-10-02

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
I20251002004336INurse PractitionerILTBD

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 62881)

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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: 8224050638View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to TARA FLEEMAN?
NPI 1124838065 is assigned to TARA FLEEMAN under the national enumeration system.
Is TARA FLEEMAN's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does TARA FLEEMAN treat or focus on?
Patients typically see TARA FLEEMAN under the specialty Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is TARA FLEEMAN's primary listing?
We display Salem, Illinois because that is what the record indicates for TARA FLEEMAN.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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