BETHANY GOTTLIEB CRNA
NPI 1174592257
Nurse Anesthetist, Certified Registered in Peoria, IL

Q: What is Bethany Gottlieb's NPI number?

The NPI number for Bethany Gottlieb is 1174592257. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Bethany Gottlieb's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Bethany Gottlieb was last updated on February 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 14, 2006Accepts Medicare Assignment

7309 N KNOXVILLE AVE, PEORIA, IL 61614(309) 282-0827(309) 683-1003 Get Directions Write a Review

NPPES record last updated: February 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Bethany Gottlieb Crna NPPES

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

BETHANY GOTTLIEB CRNA (NPI 1174592257) is an individual nurse anesthetist, certified registered in Peoria, Illinois, licensed in Illinois (209003507) and active in the NPI registry since March 2006. She is affiliated with St Johns Hospital and is a graduate of Other (2001).

NPPES Registry Identity

NPI1174592257

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameBETHANY GOTTLIEBCredential: CRNA

Location Address7309 N KNOXVILLE AVEPeoria, IL 61614-2085

Mailing Address6202 Hartford DrPekin, IL 61554-9226 · (309) 282-0827 · Fax (309) 683-1003

Phone(309) 282-0827

Fax(309) 683-1003

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateMarch 14, 2006

Last NPPES UpdateFebruary 7, 2023

NPPES CertifiedFebruary 7, 2023

✔ NPI 1174592257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in IL · 209003507

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.

7309 N KNOXVILLE AVE, Peoria, IL 61614

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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

Bethany Gottlieb Crna 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 ID4981625662

PECOS Enrollment IDI20051208000936

Hospital Affiliations CMS Care Compare

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61614 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.

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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.

ROB WIMMER P.A.

Physician Assistant (Surgical)