HEARTLAND PEDIATRIC CLINIC – Rural Health Clinic/Center, NPI 1053413740

HEARTLAND PEDIATRIC CLINIC is a healthcare provider. based in Marion, Illinois. specializing in Rural Health Clinic/Center. The NPI Number for HEARTLAND PEDIATRIC CLINIC is 1053413740

Main info

Organization
Name
HEARTLAND PEDIATRIC CLINIC
NPI
1053413740
Phone
(618) 993-5274
Address
PO BOX 1866
Authorized Official
DR. LUIS ALBERTO LOPEZ PRESIDENT/PHYSICIAN M.D.
Enumeration Date
2 September 2006
Last Update Date
1 September 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:19State licenses:0Digital endpointsOther names

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Provider Addresses for HEARTLAND PEDIATRIC CLINIC

  • Marion Post Office, East Main Street, Marion, Williamson County, Illinois, 62959, United States

    MARION, IL 629598066

    Phone: (618) 993-5274

    Fax: (618) 993-0639

    Type: Mailing

  • 1000, West Deyoung Street, Marion, Williamson County, Illinois, 62959, United States

    MARION, IL 629591630

    Phone: (618) 993-5274

    Fax: (618) 999-0639

    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: 2010-11-05

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
O20101105000587ORural Health ClinicILTBD

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

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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 62959)

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Reviews

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Frequently asked questions

Is HEARTLAND PEDIATRIC CLINIC listed with a National Provider Identifier?
Yes — HEARTLAND PEDIATRIC CLINIC has NPI 1053413740 on file in the registry.
Is HEARTLAND PEDIATRIC CLINIC still an active registrant?
HEARTLAND PEDIATRIC CLINIC carries an active NPI according to the public dataset.
What kind of doctor is HEARTLAND PEDIATRIC CLINIC?
HEARTLAND PEDIATRIC CLINIC is associated with Rural Health Clinic/Center in the directory — Clinical services aligned with this taxonomy classification.
Is HEARTLAND PEDIATRIC CLINIC located near Marion?
HEARTLAND PEDIATRIC CLINIC currently maps to Marion, Illinois in this extract.
When was this NPI issued?
Enumeration for HEARTLAND PEDIATRIC CLINIC is noted as September 2, 2006 where the registry provides it.

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