IVANNA SANDERS (PA-C) – Physician Assistant, NPI 1174174536
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for IVANNA SANDERS (PA-C)
2200 E Washington St
Bloomington, IL 617014364
Phone: (630) 468-0252
Type: Location
922 WATERVIEW WAY APT G
CHAMPAIGN, IL 618221275
Phone: (630) 468-0252
Type: Mailing
Saint Joseph Medical Center, 2200, East Washington Street, Bloomington, McLean County, Illinois, 61701, United States
BLOOMINGTON, IL 617014364
Phone: (630) 468-0252
Type: Location
1818 E WINDSOR RD
URBANA, IL 618029566
Phone:
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: 2019-10-25
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 |
|---|---|---|---|---|
| I20191025000048 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 34 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 36 | 35 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 14 | 14 | $0 |
Insurance plans in this area (ZIP 61701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | IL | |
| Nurse Practitioner | IL | |
| Clinical Psychologist | IL | |
| - | FL | |
| Nurse Practitioner | IL | |
| Gastroenterology, Internal Medicine | WI | |
| P O D I A T R Y | IL | |
| Hospitalist, Family Practice | TX | |
| - | IL | |
| - | IL |
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