DR. KELVIN EARL WYNN MD
NPI 1104928639
Family Medicine in Peoria, IL

Q: What is Kelvin Wynn's NPI number?

The NPI number for Kelvin Wynn is 1104928639. It was assigned to this individual provider in the NPPES registry on September 4, 2006.

Q: What is Kelvin Wynn's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelvin Wynn was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since September 04, 2006PECOS EnrolledAccepts Medicare Assignment

815 MAIN ST STE A, PEORIA, IL 61602(309) 672-4977 Get Directions Write a Review

NPPES record last updated: February 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 4, 2026, Nov 1, 2017 (2 updates tracked since 2017).

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About Dr. Kelvin Earl Wynn Md NPPES

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

DR. KELVIN EARL WYNN MD (NPI 1104928639) is an individual family medicine provider in Peoria, Illinois, licensed in North Carolina (34210) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and maintains a secondary practice location in Maryville.

NPPES Registry Identity

NPI1104928639

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KELVIN EARL WYNNCredential: MD

Location Address815 MAIN ST STE APeoria, IL 61602-1080

Mailing Address815 Main St Ste APeoria, IL 61602-1080 · (309) 672-4977

Phone(309) 672-4977

Sole ProprietorYes

Medical School CMSHoward University College Of MedicineGraduated 1988

Enumeration DateSeptember 4, 2006

Last NPPES UpdateFebruary 4, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2026

✔ NPI 1104928639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NC · 34210

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

815 MAIN ST STE A, Peoria, IL 61602

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Secondary Practice Location 1

Location 12148 Vadalabene DrMaryville, IL 62062-5632 · Phone (618) 877-4420

Other Identifiers 1

Other036117956IL · License

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

Dr. Kelvin Earl Wynn Md 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 ID2264538404

PECOS Enrollment IDI20070503000466

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 Reassignments

Medicare enrollment records show Kelvin Wynn reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Methodist Medical Center Of Illinois

0.2 mi

Family Medicine

120 NE GLEN OAK AVE, SUITE 101
Peoria, IL 61603

Reassigned Medicare billing, Illinois enrollment
693 clinicians in this Medicare group

NPI 1184670663 (309) 671-8230

Chestnut Health Systems Inc

33 mi

Rehabilitation, Substance Use Disorder

1003 MARTIN LUTHER KING DR
Bloomington, IL 61701

Reassigned Medicare billing, Illinois enrollment
90 clinicians in this Medicare group

NPI 1366431686 (309) 827-6026

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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

108 services83 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

86 services47 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

42 services17 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

35 services27 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

30 services30 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

19 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

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 61602 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers13 claims52 services$5.29 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$21.30 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier12 claims12 services$6.12 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers23 claims23 services$105.82 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier11 claims11 services$33.22 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

1 supplier11 claims1,020 services$0.07 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

IRAM YUNUS

Family Medicine