ROBERTO GORDILLO PEREZ MD
NPI 1407084759
Pediatrics - Pediatric Nephrology in Peoria, IL

Q: What is Roberto Gordillo Perez's NPI number?

The NPI number for Roberto Gordillo Perez is 1407084759. It was assigned to this individual provider in the NPPES registry on June 25, 2009. The provider is also known as Roberto Gordillo.

Q: What is Roberto Gordillo Perez's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Active since June 25, 2009PECOS EnrolledAccepts Medicare Assignment

530 NE GLEN OAK AVE, DEPARTMENT OF PEDIATRICS, PEORIA, IL 61637(309) 624-3313(309) 655-2565 Get Directions Write a Review

NPPES record last updated: April 12, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Roberto Gordillo Perez Md NPPES

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

ROBERTO GORDILLO PEREZ MD (NPI 1407084759) is an individual pediatric nephrology provider in Peoria, Illinois, licensed in Illinois (036.126924) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Seattle Children's Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1407084759

Entity TypeIndividualMale

Primary Taxonomy2080P0210X

Provider Legal NameROBERTO GORDILLO PEREZCredential: MD

Location Address530 NE GLEN OAK AVE, DEPARTMENT OF PEDIATRICSPeoria, IL 61637-0001

Mailing Address530 Ne Glen Oak Ave, Department Of PediatricsPeoria, IL 61637-0001 · (309) 624-3313 · Fax (309) 655-2565

Phone(309) 624-3313

Fax(309) 655-2565

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateJune 25, 2009

Last NPPES UpdateApril 12, 2011

✔ NPI 1407084759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0210X

License✔ Licensed in IL · 036.126924

Definition

A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.

Also ListedPediatricsTaxonomy 208000000X · License 036.126924 (IL)

530 NE GLEN OAK AVE, Peoria, IL 61637

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Other Names 1

Professional Name (2)Roberto Gordillo

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Roberto Gordillo Perez Md 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 ID5193878627

PECOS Enrollment IDI20160705000875

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

Medicare enrollment records show Roberto Gordillo Perez reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Multicare Health System

1,444 mi

Internal Medicine

15533 E BROADWAY AVE
Spokane Valley, WA 99037

Reassigned Medicare billing, Washington enrollment
4,383 clinicians in this Medicare group

NPI 1336902345 (509) 530-4260

Association Of Chmc And University Physicians

1,531 mi

Pediatrics

969 STEVENS DR, SUITE 1B
Richland, WA 99352

Reassigned Medicare billing, Washington enrollment
Medicare enrollment name: The Association Of Chrmc And University Physicians
1,443 clinicians in this Medicare group

NPI 1851680664 (509) 946-0976

Seattle Children's Hospital

1,679 mi

Primary Care

3939 S OTHELLO ST STE 101
Seattle, WA 98118

Reassigned Medicare billing, Washington enrollment
Medicare enrollment name: Seattle Childrens Hospital
912 clinicians in this Medicare group

NPI 1134251747 (206) 987-7200

The Association Of University Physicians

1,682 mi

Anesthesiology

701 5TH AVE, SUITE 700
Seattle, WA 98104

Reassigned Medicare billing, Washington enrollment
4,364 clinicians in this Medicare group

NPI 1023041159 (206) 543-6420

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

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.

25 services14 patients

Hospital Affiliations CMS Care Compare

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

Seattle Children's Hospital

Childrens · Seattle, WA

OwnershipVoluntary non-profit - Private

CMS Certification Number503300

Location4800 Sand Point Way NE, PO Box C-5371Seattle, WA 98105 · King County

Emergency services

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503

Treatment-Chemotherapy · category RH002N

2 suppliers17 claims7,200 services$1.19 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

5 suppliers15 claims1,980 services$0.13 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

5 suppliers16 claims16 services$18.96 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

5 suppliers15 claims15 services$12.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. HAMID MAHMOOD ZIA M.D

Pathology (Anatomic Pathology & Clinical Pathology)

530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637

Peoria County (309) 624-9011

THOMAS JAMES MCMORROW MD

Pediatrics