Belleville Pediatric & Adolescent Health Center – Federally Qualified Health Center (FQHC), NPI 1376588871

Belleville Pediatric & Adolescent Health Center is a healthcare provider. based in Sauget, Illinois. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Belleville Pediatric & Adolescent Health Center is 1376588871

Main info

Organization
Name
Belleville Pediatric & Adolescent Health Center
NPI
1376588871
Phone
(618) 332-0953
Address
2041 GOOSE LAKE RD
Authorized Official
MR. LARRY MCCULLEY CEO
Enumeration Date
18 June 2006
Last Update Date
8 August 2014
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Belleville Pediatric & Adolescent Health Center

  • Goose Lake, Sauget, Saint Clair County, Illinois, 62207, United States

    SAUGET, IL 622062822

    Phone: (618) 332-0953

    Fax: (618) 332-2487

    Type: Mailing

  • Frank Scott Parkway West, Gartside, Belleville, Saint Clair County, Illinois, 62223, United States

    SUITE 950

    BELLEVILLE, IL 622235000

    Phone: (618) 233-3205

    Fax: (618) 233-1407

    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: 2014-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-04-30 (38 days ago).

Enrollment records

1

Earliest due date

2026-04-30

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
O20140820001464OFederally Qualified Health Center (Fqhc)IL2026-04-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 62206)

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Reviews

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Frequently asked questions

What NPI should I save for Belleville Pediatric & Adolescent Health Center?
Save NPI 1376588871 if you need a stable reference for Belleville Pediatric & Adolescent Health Center.
Is Belleville Pediatric & Adolescent Health Center's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize Belleville Pediatric & Adolescent Health Center's specialty in plain language?
Clinically, the directory lists Belleville Pediatric & Adolescent Health Center with Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Where is Belleville Pediatric & Adolescent Health Center's primary listing?
We display Sauget, Illinois because that is what the record indicates for Belleville Pediatric & Adolescent Health Center.
Is Belleville Pediatric & Adolescent Health Center a real provider?
This page reflects official NPPES data for NPI 1376588871. Always confirm identity and privileges with the practice and licensing boards.

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