TARA BRINKOETTER – Clinical Social Worker, NPI 1669639050

TARA BRINKOETTER is a healthcare provider. based in Normal, Illinois. specializing in CLINICAL SOCIAL WORKER. The NPI Number for TARA BRINKOETTER is 1669639050

Main info

Female
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
TARA BRINKOETTER
NPI
1669639050
Phone
(217) 855-7777
Address
1698 FORT JESSE RD
Enumeration Date
22 May 2008
Last Update Date
20 October 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2178723800
Graduation Year
2008 (18 years ago)
PAC ID
4587912803
Group Practice PAC ID
4486667888
Professional Enrollment ID
I20180802002611
Address ID
IL625264379DE102XXAVEX401

Contacts

Secure Messaging
tarabrinkoetter@sium.allscriptsdirect.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:18State licenses:0Other namesUpdated within 12 months

3,510 CLINICAL SOCIAL WORKER in IL

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Provider Addresses for TARA BRINKOETTER

  • 1698, Fort Jesse Road, Normal, McLean County, Illinois, 61704, United States

    APT. 4

    NORMAL, IL 617612219

    Phone: (217) 855-7777

    Type: Mailing

  • 108, West Market Street, Bloomington, McLean County, Illinois, 61701, United States

    BLOOMINGTON, IL 617013918

    Phone: (309) 827-5351

    Fax: (309) 829-6808

    Type: Location

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: 2018-08-02

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
I20180802002611IClinical Social WorkerILTBD

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 61761)

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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: 4486667888View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Physician AssistantIL
Family PracticeIL
Registered Dietitian Or Nutrition ProfessionalIL
Clinical Social WorkerIL
Nurse PractitionerIL
Mental Health CounselorIL
-IL
Internal MedicineOK
Family PracticeIL

Reviews

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Frequently asked questions

What NPI should I save for TARA BRINKOETTER?
Save NPI 1669639050 if you need a stable reference for TARA BRINKOETTER.
Is TARA BRINKOETTER's NPI currently valid?
The extract we use shows TARA BRINKOETTER as active.
What field does TARA BRINKOETTER work in?
You can think of TARA BRINKOETTER as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does TARA BRINKOETTER practice in Illinois?
You will see Normal, Illinois on file for TARA BRINKOETTER alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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