ALYVE MEDICAL PLLC FAMILY MEDICAL CLINIC
NPI 1295495208
Internal Medicine - Obesity Medicine in O Fallon, IL
About Alyve Medical Pllc Family Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALYVE MEDICAL PLLC FAMILY MEDICAL CLINIC (NPI 1295495208) is a healthcare organization registered as an obesity medicine in O Fallon, Illinois and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through January 26, 2028 and lists Amardeep Shrestha, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alyve Medical Pllc Family Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Alyve Medical PLLC Family Medical Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 14D2250504
Alyve Medical PLLC · O Fallon, ILFrequently 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 Alyve Medical PLLC Family Medical Clinic's NPI number?
The NPI number for Alyve Medical PLLC Family Medical Clinic is 1295495208. It was assigned to this organization in the NPPES registry on December 20, 2021.
Where is Alyve Medical PLLC Family Medical Clinic located?
Alyve Medical PLLC Family Medical Clinic is located at 1480 N Green Mount Rd Ste 200, O Fallon, IL 62269. The listed phone number is (618) 622-3450.
What is Alyve Medical PLLC Family Medical Clinic's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.
Is Alyve Medical PLLC Family Medical Clinic enrolled in Medicare?
Yes. Alyve Medical PLLC Family Medical Clinic is registered in the Medicare PECOS enrollment system.
When is Alyve Medical PLLC Family Medical Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Alyve Medical PLLC Family Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Alyve Medical PLLC Family Medical Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Alyve Medical PLLC Family Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D2250504) is associated with this NPI, valid through January 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Alyve Medical PLLC Family Medical Clinic was last updated on January 6, 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.
# Alyve Medical Pllc Family Medical Clinic · NPI 1295495208
Obesity Medicine organization in O Fallon, Illinois. Organization record, active in the CMS NPPES registry since December 20, 2021.
## Identity
- **NPI:** 1295495208 (Entity type: Organization)
- **Enumerated:** December 20, 2021
- **Primary specialty:** Internal Medicine - Obesity Medicine · taxonomy 207RB0002X
- **Organization subpart:** No
- **Authorized official:** Amardeep Shrestha, MANAGER
## Practice location
- **Address:** 1480 N GREEN MOUNT RD STE 200, O Fallon, IL 62269-3466
- **Phone:** (618) 622-3450 · **Fax:** (618) 622-3468
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Illinois, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 6, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1295495208) · Data from the CMS NPPES public registry.