Unknown Individual – Emergency Medicine Physician, NPI 1508839895
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1404, North Maple Street, Northgate, Normal, McLean County, Illinois, 61761, United States
NORMAL, IL 617611422
Phone: (309) 452-8404
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 28 Open Payments records for all available years, with a total value of $59,615.
Total Amount is formed as General ($59,615) + Research ($0) + Ownership ($0) = $59,615.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Kedplasma LLC ($42,640).
Total Amount
$59,615
General + Research + Ownership
Payments
28
Total payment records
General Amount
$59,615
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kedplasma LLC | $42,640 |
| CSL Plasma Inc. | $16,975 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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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Reviews
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