MR. DAVID WILLIAM III JANTZEN (M.D.) – Pediatric Cardiology Physician, NPI 1649451352
Pediatric Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,594 CARDIOVASCULAR DISEASE (CARDIOLOGY) in IL
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Provider Addresses for MR. DAVID WILLIAM III JANTZEN (M.D.)
420, Northeast Glen Oak Avenue, Peoria, Peoria County, Illinois, 61603, United States
SUITE 301
PEORIA, IL 616033105
Phone: (309) 655-3453
Fax: (309) 655-3410
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 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2023-03-04 • Largest payer in this snapshot: Medtronic, Inc. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $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: 2020-07-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200717001187 | I | Pediatric Medicine | NE | 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 61603)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NE | |
| Infectious Disease | NE | |
| N E U R O L O G Y | NE | |
| P A T H O L O G Y | NE | |
| Medical Oncology, Hematology/Oncology | NE | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NE | |
| - | NE | |
| G A S T R O E N T E R O L O G Y | NE | |
| Internal Medicine | NE | |
| N E U R O S U R G E R Y | NE |
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