BRIAN BOSTWICK (MD) – Pediatrics Physician, NPI 1891768636

BRIAN BOSTWICK (MD) is a healthcare provider. based in Peoria, Illinois. specializing in Pediatrics Physician. They hold the professional credentials MD. They hold a License No. 036106503 (IL). The NPI Number for BRIAN BOSTWICK (MD) is 1891768636

Main info

Male
Name
BRIAN BOSTWICK (MD)
NPI
1891768636
Phone
(309) 655-3292
Address
530 NE GLEN OAK AVE
Enumeration Date
10 February 2006
Last Update Date
20 October 2020

Contacts

Secure Messaging
brianbostwick@siusm.allscriptsdirect.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for BRIAN BOSTWICK (MD)

  • Saint Francis Medical Center, 530, Northeast Glen Oak Avenue, Peoria, Peoria County, Illinois, 61637, United States

    PEORIA, IL 616370001

    Phone: (309) 655-3292

    Fax: (309) 655-7732

    Type: Mailing

  • 301, North 8th Street, Springfield, Sangamon County, Illinois, 62701, United States

    PAV 4A

    SPRINGFIELD, IL 62702

    Phone: (217) 545-8000

    Fax: (217) 545-2303

    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: 2004-05-10

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
I20040510001387IPediatric MedicineILTBD

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 61637)

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Reviews

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Frequently asked questions

Is there an official ID for BRIAN BOSTWICK (MD) in U.S. healthcare records?
The official identifier for BRIAN BOSTWICK (MD) is NPI 1891768636.
Would BRIAN BOSTWICK (MD) appear as active to a payer?
You can treat BRIAN BOSTWICK (MD) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is BRIAN BOSTWICK (MD)?
BRIAN BOSTWICK (MD) is associated with Pediatrics Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with BRIAN BOSTWICK (MD)?
Directory geography for BRIAN BOSTWICK (MD) centers on Peoria, Illinois.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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