TRACEY SAMANTHA PEACHEY (FNP) – Nurse Practitioner, NPI 1124872924
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for TRACEY SAMANTHA PEACHEY (FNP)
401 N WALL ST STE 102
KANKAKEE, IL 609012934
Phone: (815) 928-5090
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)
CMS reports 6 Open Payments records for all available years, with a total value of $116.
Total Amount is formed as General ($116) + Research ($0) + Ownership ($0) = $116.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Novo Nordisk Inc ($31).
Total Amount
$116
General + Research + Ownership
Payments
6
Total payment records
General Amount
$116
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $31 |
| Dexcom, Inc. | $30 |
| PFIZER INC. | $24 |
| Lundbeck LLC | $16 |
| Salix Pharmaceuticals, a division of Bausch Health US, LLC | $14 |
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: 2024-08-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240814001704 | I | Nurse Practitioner | IL | TBD |
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.
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 60901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| N E U R O L O G Y | IL | |
| Physician Assistant | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| Family Practice | IL | |
| N E U R O L O G Y | NY |
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