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MELINDA SUE HICKEY MSN, AGNP-C, CWON
NPI 1396453346
Nurse Practitioner - Primary Care in Peoria, IL

Active since November 08, 2022PECOS Enrolled
221 NE GLEN OAK AVE, PEORIA, IL 61636(309) 678-2218 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 13, 2025, Nov 8, 2022 (2 updates tracked since 2022).

About Melinda Sue Hickey Msn, Agnp-c, Cwon NPPES

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

MELINDA SUE HICKEY MSN, AGNP-C, CWON (NPI 1396453346) is an individual primary care provider in Peoria, Illinois, licensed in Illinois (AG09220121) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396453346
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameMELINDA SUE HICKEYCredential: MSN, AGNP-C, CWON
Location Address221 NE GLEN OAK AVEPeoria, IL 61636-0001
Mailing Address355 S Bridge StBanner, IL 61520-9307 · (309) 650-0615
Phone(309) 678-2218
Sole ProprietorNo
Enumeration DateNovember 8, 2022
Last NPPES UpdateMay 13, 20252 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
✔ NPI 1396453346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in IL · AG09220121
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 209027429 (IL)
221 NE GLEN OAK AVE, Peoria, IL 61636
Open in Google Maps ↗

Other Names 1

Other Name (5)Melinda Sue Gangloff

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Melinda Sue Hickey Msn, Agnp-c, Cwon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Melinda Hickey reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Methodist Medical Center Of Illinois
Same address
General Acute Care Hospital
221 NE GLEN OAK AVE
Peoria, IL 61636
  • Reassigned Medicare billing, Illinois enrollment
  • 693 clinicians in this Medicare group
NPI 1164474755 (309) 672-5522
Carle Health Medical Group
83 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61636 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
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.

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.

BRYCE HAMAMOTO
Student in an Organized Health Care Education/Training Program
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
RIAZ SHAH MD
Internal Medicine
221 NE GLEN OAK AVE, SUITE 504
PEORIA, IL 61636
Peoria County (309) 672-5729
CENTRAL ILLINOIS RADIATION ONCOLOGY PHYSICIANS, LTD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5700
MIHAILO NIKOLIC
Nurse Anesthetist, Certified Registered
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5654
WAQAS ALI MD
Internal Medicine
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
ANNE LOOK APN
Nurse Practitioner (Acute Care)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
DR. KENNETH STRUM M.D.
Anesthesiology
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 369-1761
DR. ANDREW BRIAN ARMSTRONG M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-4920

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 Melinda Hickey's NPI number?

The NPI number for Melinda Hickey is 1396453346. It was assigned to this individual provider in the NPPES registry on November 8, 2022. The provider is also known as Melinda Sue Gangloff.

Where is Melinda Hickey located?

Melinda Hickey practices at 221 NE Glen Oak Ave, Peoria, IL 61636. The listed phone number is (309) 678-2218.

What is Melinda Hickey's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Melinda Hickey enrolled in Medicare?

Yes. Melinda Hickey is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Melinda Hickey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melinda Hickey reassigns Medicare benefits to 2 organizations: Methodist Medical Center Of Illinois (Peoria, IL) and Carle Health Medical Group (Urbana, 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 Melinda Hickey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Melinda Hickey was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.