PREMIUMHEALTHCARE PC
NPI 1386184448
Internal Medicine in Crest Hill, IL
About Premiumhealthcare Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIUMHEALTHCARE PC (NPI 1386184448) is a healthcare organization registered as an internal medicine in Crest Hill, Illinois and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through April 5, 2028, maintains a secondary practice location in Downers Grove, and lists Jose F Rivera Guerrero, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Premiumhealthcare Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Premiumhealthcare PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 14D2133911
Premium Health Care PC · Crest Hill, 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 Premiumhealthcare PC's NPI number?
The NPI number for Premiumhealthcare PC is 1386184448. It was assigned to this organization in the NPPES registry on March 8, 2017.
Where is Premiumhealthcare PC located?
Premiumhealthcare PC is located at 16003 Executive Dr, Crest Hill, IL 60403. The listed phone number is (815) 838-9544.
What is Premiumhealthcare PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Premiumhealthcare PC enrolled in Medicare?
Yes. Premiumhealthcare PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Premiumhealthcare PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Premiumhealthcare PC. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Premiumhealthcare PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D2133911) is associated with this NPI, valid through April 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Premiumhealthcare PC accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Premiumhealthcare PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Premiumhealthcare PC was last updated on February 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Premiumhealthcare Pc · NPI 1386184448
Internal Medicine organization in Crest Hill, Illinois. Organization record, active in the CMS NPPES registry since March 8, 2017.
## Identity
- **NPI:** 1386184448 (Entity type: Organization)
- **Enumerated:** March 8, 2017
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Jose Rivera Guerrero, OWNER
## Practice location
- **Address:** 16003 EXECUTIVE DR, Crest Hill, IL 60403-0500
- **Phone:** (815) 838-9544
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 7, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1386184448) · Data from the CMS NPPES public registry.