ELIZABETH J PUTHENVEETIL M.D.
NPI 1417058256
Family Medicine in Galesburg, IL

Q: What is Elizabeth Puthenveetil's NPI number?

The NPI number for Elizabeth Puthenveetil is 1417058256. It was assigned to this individual provider in the NPPES registry on September 26, 2006. The provider is also known as Elizabeth J Mathal M.D..

Q: What is Elizabeth Puthenveetil's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 26, 2006PECOS EnrolledAccepts Medicare Assignment

1707 N HENDERSON ST, GALESBURG, IL 61401(309) 343-1000(309) 344-1054 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Elizabeth J Puthenveetil M.d. NPPES

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

ELIZABETH J PUTHENVEETIL M.D. (NPI 1417058256) is an individual family medicine provider in Galesburg, Illinois and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1417058256

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameELIZABETH J PUTHENVEETILCredential: M.D.

Location Address1707 N HENDERSON STGalesburg, IL 61401-1320

Mailing Address1707 N Henderson StGalesburg, IL 61401-1320 · (309) 343-1000 · Fax (309) 344-1054

Phone(309) 343-1000

Fax(309) 344-1054

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateSeptember 26, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1417058256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1707 N HENDERSON ST, Galesburg, IL 61401

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Other Names 1

Former Name (1)Elizabeth J Mathal M.d.

Other Identifiers 6

Other7191392Aetna

Medicare ID-Type Unspecified530390

Other4815127Bc/bs

Medicare UPINH76079

Other11053987IL · Caqh

Other364271985-29John Deere

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

Elizabeth J Puthenveetil M.d. 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 ID6507852977

PECOS Enrollment IDI20040421001455

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 Elizabeth Puthenveetil reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St Mary Medical Center

1.7 mi

Family Medicine

3375 N SEMINARY ST
Galesburg, IL 61401

Reassigned Medicare billing, Illinois enrollment
101 clinicians in this Medicare group

NPI 1457308710 (800) 589-6070

Osf Multi-Specialty Group

39 mi

Internal Medicine

8600 N STATE ROUTE 91
Peoria, IL 61615

Reassigned Medicare billing, Illinois enrollment
2,944 clinicians in this Medicare group

NPI 1154908929 (309) 683-5050

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

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

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140064

Location3333 North SeminaryGalesburg, IL 61401 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61401 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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK A WIECHERT M.D.

Emergency Medicine

1707 N HENDERSON ST
GALESBURG, IL 61401

Knox County (309) 343-1000

ST. MARY MEDICAL CENTER

General Acute Care Hospital (Rural)

1707 N HENDERSON ST
GALESBURG, IL 61401

Knox County (309) 343-1000

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 Elizabeth Puthenveetil's NPI number?

The NPI number for Elizabeth Puthenveetil is 1417058256. It was assigned to this individual provider in the NPPES registry on September 26, 2006. The provider is also known as Elizabeth J Mathal M.D..

Where is Elizabeth Puthenveetil located?

Elizabeth Puthenveetil practices at 1707 N Henderson St, Galesburg, IL 61401. The listed phone number is (309) 343-1000.

What is Elizabeth Puthenveetil's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Elizabeth Puthenveetil enrolled in Medicare?

Yes. Elizabeth Puthenveetil 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 Elizabeth Puthenveetil's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elizabeth Puthenveetil reassigns Medicare benefits to 2 organizations: St Mary Medical Center (Galesburg, IL) and Osf Multi-Specialty Group (Peoria, 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 Elizabeth Puthenveetil's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Elizabeth Puthenveetil affiliated with any hospitals?

According to CMS data, Elizabeth Puthenveetil is affiliated with St Mary Medical Center.

When was this NPI record last updated?

The NPPES record for Elizabeth Puthenveetil was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.