MRS. TIARA J MULLEN (APRN) – Family Nurse Practitioner, NPI 1164062196
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MRS. TIARA J MULLEN (APRN)
420 NE GLEN OAK AVE STE 401
PEORIA, IL 616033112
Phone: (309) 676-8123
Fax: (309) 676-8455
Type: Mailing
420 NE GLEN OAK AVE
PEORIA, IL 616033106
Phone: (309) 676-8123
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: 2020-04-24
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 |
|---|---|---|---|---|
| I20200424001232 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90960 | Dialysis services, 4 or more physician visits per month (20 years or older) | 42 | 29 | $0 |
| 90961 | Dialysis services, 2-3 physician visits per month (20 years or older) | 39 | 27 | $0 |
Insurance plans in this area (ZIP 61603)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| N E P H R O L O G Y | IL | |
| N E P H R O L O G Y | IL | |
| N E P H R O L O G Y | IL | |
| Nephrology, Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IA | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
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