NICHOLAS GUASTALLI DO
NPI 1275957334
Internal Medicine in Kankakee, IL

Q: What is Nicholas Guastalli's NPI number?

The NPI number for Nicholas Guastalli is 1275957334. It was assigned to this individual provider in the NPPES registry on February 10, 2014.

Q: What is Nicholas Guastalli's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since February 10, 2014PECOS EnrolledAccepts Medicare Assignment

401 N WALL ST STE 102, KANKAKEE, IL 60901(815) 928-5090(815) 928-5079 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Mar 22, 2021, Aug 24, 2017 (3 updates tracked since 2017).

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About Nicholas Guastalli Do NPPES

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

NICHOLAS GUASTALLI DO (NPI 1275957334) is an individual internal medicine provider in Kankakee, Illinois, licensed in Illinois (036143561) and active in the NPI registry since February 2014. He is enrolled in Medicare PECOS, is affiliated with Presence St Marys Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1275957334

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameNICHOLAS GUASTALLICredential: DO

Location Address401 N WALL ST STE 102Kankakee, IL 60901-2934

Mailing Address401 N Wall St Ste 102Kankakee, IL 60901-2934 · (815) 928-5090 · Fax (815) 928-5079

Phone(815) 928-5090

Fax(815) 928-5079

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateFebruary 10, 2014

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

NPPES CertifiedMarch 22, 2021

✔ NPI 1275957334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036143561

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

401 N WALL ST STE 102, Kankakee, IL 60901

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Nicholas Guastalli Do 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 ID5698040889

PECOS Enrollment IDI20171016000362

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 Nicholas Guastalli reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Riverside Health System

0.2 mi

Psychiatry

500 N WALL ST, SUITE 200
Kankakee, IL 60901

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

NPI 1336354430 (815) 937-1237

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 11

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 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.

852 services453 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.

417 services417 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

104 services102 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

95 services94 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.

70 services70 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

70 services59 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

42 services35 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

32 services32 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

25 services25 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

23 services23 patients

Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report G0403

An Electrocardiogram (ECG) with 12 leads is a non-invasive test that measures the electrical activity of your heart. It's performed during your initial physical examination to screen for heart conditions. The results are interpreted and compiled into a report for further evaluation.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Presence St Marys Hospital

Acute Care Hospitals · Kankakee, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140155

Location500 W Court StKankakee, IL 60901 · Kankakee County

Emergency services Birthing friendly

Riverside Medical Center

Acute Care Hospitals · Kankakee, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140186

Location350 N Wall StKankakee, IL 60901 · Kankakee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60901 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

$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 21

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

19 suppliers108 claims278 services$6.30 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

13 suppliers39 claims60 services$1.07 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604