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NICOLAS GUDINO JR.
NPI 1063833457
Counselor - Mental Health in Bloomington, IL

Active since January 02, 2014PECOS EnrolledAccepts Medicare Assignment
108 W MARKET ST, BLOOMINGTON, IL 61701(309) 827-5351(309) 829-6808 Get Directions Write a Review

NPPES record last updated: May 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicolas Gudino Jr. NPPES

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

NICOLAS GUDINO JR. (NPI 1063833457) is an individual mental health provider in Bloomington, Illinois, licensed in Illinois (180010615) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1063833457
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameNICOLAS GUDINO JR.
Location Address108 W MARKET STBloomington, IL 61701-3918
Mailing Address108 W Market StBloomington, IL 61701-3918 · (309) 827-5351
Phone(309) 827-5351
Fax(309) 829-6808
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateJanuary 2, 2014
Last NPPES UpdateMay 26, 2022
NPPES CertifiedMay 26, 2022
✔ NPI 1063833457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IL · 180010615
108 W MARKET ST, Bloomington, IL 61701
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicolas Gudino Jr. 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 ID8921440504
PECOS Enrollment IDI20240528003482
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.

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.

THERESA KAUTH
Nurse Practitioner (Family)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
TIMOTHY ROBERT WRIGHT
Counselor (Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
BRYNNA A PORCH
Registered Nurse (Psychiatric/Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
MR. JOSHUA BECKWITH
Counselor (Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
BRIDGET W MWAURA
Counselor (Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
JOANNE LILLIAN MECHERLE
Registered Nurse (Psychiatric/Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
KEVIN PETER CRUTCHER
Counselor (Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351
DEAN CONSTANTOPALOS
Counselor (Mental Health)
108 W MARKET ST
BLOOMINGTON, IL 61701
McLean County (309) 827-5351

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 Nicolas Gudino's NPI number?

The NPI number for Nicolas Gudino is 1063833457. It was assigned to this individual provider in the NPPES registry on January 2, 2014.

Where is Nicolas Gudino located?

Nicolas Gudino practices at 108 W Market St, Bloomington, IL 61701. The listed phone number is (309) 827-5351.

What is Nicolas Gudino's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Nicolas Gudino enrolled in Medicare?

Yes. Nicolas Gudino 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.

When was this NPI record last updated?

The NPPES record for Nicolas Gudino was last updated on May 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.