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MELISSA M THEOBALD FNP
NPI 1114763737
Nurse Practitioner - Family in Peoria, IL

Active since July 03, 2024PECOS EnrolledAccepts Medicare Assignment
3626 N SHERIDAN RD, PEORIA, IL 61604(309) 308-5100 Get Directions Write a Review

NPPES record last updated: October 23, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 23, 2024, Jul 3, 2024 (2 updates tracked since 2024).

About Melissa M Theobald Fnp NPPES

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

MELISSA M THEOBALD FNP (NPI 1114763737) is an individual family provider in Peoria, Illinois, licensed in Illinois (209030474) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1114763737
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMELISSA M THEOBALDCredential: FNP
Location Address3626 N SHERIDAN RDPeoria, IL 61604-1401
Mailing Address19014 N Daily RdPrinceville, IL 61559-9312 · (309) 231-2050
Phone(309) 308-5100
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 3, 2024
Last NPPES UpdateOctober 23, 20242 updates tracked since enumeration
NPPES CertifiedOctober 23, 2024
✔ NPI 1114763737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209030474
Also ListedRegistered NurseTaxonomy 163W00000X · License 041362793 (IL)
3626 N SHERIDAN RD, Peoria, IL 61604
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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

Melissa M Theobald Fnp 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 ID6709318124
PECOS Enrollment IDI20241010000700
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.

Areas of Expertise CMS Part B claims 2

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.

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.
28 services28 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61604 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.

Other Providers at the Same Location NPPES 4

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

MRS. TIFFANY ASHBY-FUNCHES APN, FNP-BC
Nurse Practitioner (Family)
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100
OSF MULTI-SPECIALTY GROUP
Non-Pharmacy Dispensing Site
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100
ALYSSA WILLIAMS BLAKE
Nurse Practitioner (Acute Care)
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100
ANDREA N MACHNACKI APRN, CNP
Nurse Practitioner (Family)
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100

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 Melissa Theobald's NPI number?

The NPI number for Melissa Theobald is 1114763737. It was assigned to this individual provider in the NPPES registry on July 3, 2024.

Where is Melissa Theobald located?

Melissa Theobald practices at 3626 N Sheridan Rd, Peoria, IL 61604. The listed phone number is (309) 308-5100.

What is Melissa Theobald's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Melissa Theobald enrolled in Medicare?

Yes. Melissa Theobald 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.

Is Melissa Theobald affiliated with any hospitals?

According to CMS data, Melissa Theobald is affiliated with Saint Francis Medical Center.

When was this NPI record last updated?

The NPPES record for Melissa Theobald was last updated on October 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.