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MIHAILO NIKOLIC
NPI 1013744879
Nurse Anesthetist, Certified Registered in Peoria, IL

Active since September 16, 2024PECOS EnrolledAccepts Medicare Assignment
221 NE GLEN OAK AVE, PEORIA, IL 61636(309) 672-5654(309) 672-5735 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mihailo Nikolic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIHAILO NIKOLIC (NPI 1013744879) is an individual nurse anesthetist, certified registered in Peoria, Illinois, licensed in Illinois (209035930) and active in the NPI registry since September 2024. He is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and maintains a secondary practice location in Tupelo.

NPPES Registry Identity

NPI1013744879
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMIHAILO NIKOLIC
Location Address221 NE GLEN OAK AVEPeoria, IL 61636-1000
Mailing Address1616 Pecan GrvTupelo, MS 38801-7182
Phone(309) 672-5654
Fax(309) 672-5735
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateSeptember 16, 2024
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1013744879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in IL · 209035930
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
221 NE GLEN OAK AVE, Peoria, IL 61636
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Secondary Practice Location 1

Location 11616 Pecan GrvTupelo, MS 38801-7182 · Phone (662) 321-3793

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mihailo Nikolic is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42784555
PECOS Enrollment IDI20260707000711
Eligible to Order & Refer✔ Part B Labs & Imaging– Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mihailo Nikolic reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carle Health Medical Group
83 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Proctor Hospital

Acute Care Hospitals · Peoria, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140013
Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County
Emergency services

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61636 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRYCE HAMAMOTO
Student in an Organized Health Care Education/Training Program
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
RIAZ SHAH MD
Internal Medicine
221 NE GLEN OAK AVE, SUITE 504
PEORIA, IL 61636
Peoria County (309) 672-5729
CENTRAL ILLINOIS RADIATION ONCOLOGY PHYSICIANS, LTD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5700
WAQAS ALI MD
Internal Medicine
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
ANNE LOOK APN
Nurse Practitioner (Acute Care)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
DR. KENNETH STRUM M.D.
Anesthesiology
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 369-1761
DR. ANDREW BRIAN ARMSTRONG M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-4920
DR. MATTHEW TRENT CARPENTER MD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE, DEPARTMENT OF RADIATION ONCOLOGY
PEORIA, IL 61636
Peoria County (309) 672-5700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mihailo Nikolic's NPI number?

The NPI number for Mihailo Nikolic is 1013744879. It was assigned to this individual provider in the NPPES registry on September 16, 2024.

Where is Mihailo Nikolic located?

Mihailo Nikolic practices at 221 NE Glen Oak Ave, Peoria, IL 61636. The listed phone number is (309) 672-5654.

What is Mihailo Nikolic's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Mihailo Nikolic enrolled in Medicare?

Yes. Mihailo Nikolic is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Mihailo Nikolic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mihailo Nikolic reassigns Medicare benefits to Carle Health Medical Group (Urbana, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mihailo Nikolic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Mihailo Nikolic affiliated with any hospitals?

According to CMS data, Mihailo Nikolic is affiliated with Proctor Hospital and Methodist Medical Center Of Illinois.

When was this NPI record last updated?

The NPPES record for Mihailo Nikolic was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.