ALEC NEITZEL – Physician Assistant, NPI 1366260820

ALEC NEITZEL is a healthcare provider. based in Urbana, Illinois. specializing in PHYSICIAN ASSISTANT. The NPI Number for ALEC NEITZEL is 1366260820

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
ALEC NEITZEL
NPI
1366260820
Phone
Not provided
Address
1111 W KENYON RD STE B
Enumeration Date
2 October 2024
Last Update Date
2 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2172053376
Graduation Year
2024 (2 years ago)
PAC ID
9739690660
Group Practice PAC ID
5991116261
Professional Enrollment ID
I20250617002346
Address ID
IL619384210MA917XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for ALEC NEITZEL

  • 1111 W KENYON RD STE B

    URBANA, IL 618011006

    Phone:

    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: 2025-06-17

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
I20250617002346IPhysician AssistantILTBD

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 61801)

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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: 5991116261View full group profile
NameSpecialtyState
D E R M A T O L O G YIL
Nurse PractitionerIL
Nurse PractitionerKY
Physician AssistantIN
Nurse PractitionerKY
D E R M A T O L O G YMI
D E R M A T O L O G YIL
Physician AssistantIL
D E R M A T O L O G YPA
Physician AssistantIL

Reviews

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Frequently asked questions

Does ALEC NEITZEL have a public NPI I can cite?
Public records show ALEC NEITZEL under NPI 1366260820.
Quick check: is ALEC NEITZEL active?
Public NPPES data shows ALEC NEITZEL with an active NPI status right now.
How should patients interpret ALEC NEITZEL's specialty?
The extract shows Physician Assistant for ALEC NEITZEL. Clinical services aligned with this taxonomy classification.
Can patients visit ALEC NEITZEL in Urbana, Illinois?
For routing, start with Urbana, Illinois for ALEC NEITZEL, then verify phone and hours locally.
Why is information missing for ALEC NEITZEL?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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