PEKIN PROHEALTH INC – Family Medicine Physician, NPI 1932150299
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PEKIN PROHEALTH INC
Pekin Hospital, 600, South 13th Street, Pekin, Tazewell County, Illinois, 61554, United States
SUITE M
PEKIN, IL 615544936
Phone: (309) 353-0825
Fax: (309) 347-1246
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)
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: 2021-07-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-05-31 (10 days ago).
Enrollment records
5
Earliest due date
2026-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031120000522 | O | Clinic/Group Practice | IL | 2026-09-30 |
| O20200409001119 | O | Clinic/Group Practice | FL | 2026-05-31 |
| O20200924002784 | O | Clinic/Group Practice | VA | 2026-06-30 |
| O20210317001495 | O | Clinic/Group Practice | PA | 2026-07-31 |
| O20210702002317 | O | Clinic/Group Practice | MI | 2026-08-31 |
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.
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 61554)
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