STEFANIE POETTKER
NPI 1376417253
Nurse Practitioner in Centralia, IL
About Stefanie Poettker NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEFANIE POETTKER (NPI 1376417253) is an individual nurse practitioner in Centralia, Illinois, licensed in Illinois (209.033426) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and maintains a secondary practice location in West Frankfort.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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
Stefanie Poettker 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.
Medicare Billing Reassignments
2Medicare enrollment records show Stefanie Poettker reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Salem, IL 62881
- Reassigned Medicare billing, Illinois enrollment
- 228 clinicians in this Medicare group
Herrin, IL 62948
- Reassigned Medicare billing, Illinois enrollment
- 44 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Herrin Hospital
Acute Care Hospitals · Herrin, ILMemorial Hospital Of Carbondale
Acute Care Hospitals · Carbondale, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Stefanie Poettker's NPI number?
The NPI number for Stefanie Poettker is 1376417253. It was assigned to this individual provider in the NPPES registry on October 2, 2025.
Where is Stefanie Poettker located?
Stefanie Poettker practices at 130 S Lincoln Blvd, Centralia, IL 62801. The listed phone number is (618) 993-0404.
What is Stefanie Poettker's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Stefanie Poettker enrolled in Medicare?
Yes. Stefanie Poettker 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.
Which organizations bill Medicare for Stefanie Poettker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stefanie Poettker reassigns Medicare benefits to 2 organizations: Deaconess Illinois Specialty Clinic, Inc. (Salem, IL) and Southern Orthopedic Associates Sc (Herrin, IL). Each 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 Stefanie Poettker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Stefanie Poettker affiliated with any hospitals?
According to CMS data, Stefanie Poettker is affiliated with Herrin Hospital and Memorial Hospital Of Carbondale.
When was this NPI record last updated?
The NPPES record for Stefanie Poettker was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days 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.
# Stefanie Poettker · NPI 1376417253
Nurse Practitioner physician in Centralia, Illinois. Individual provider, active in the CMS NPPES registry since October 2, 2025.
## Identity
- **NPI:** 1376417253 (Entity type: Individual)
- **Enumerated:** October 2, 2025
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 209.033426 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 130 S LINCOLN BLVD, Centralia, IL 62801-3654
- **Phone:** (618) 993-0404
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Deaconess Illinois Specialty Clinic, Inc. (NPI 1730896291, Salem, IL); Southern Orthopedic Associates Sc (NPI 1396792412, Herrin, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** September 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1376417253) · Data from the CMS NPPES public registry.