MEMORIAL PHYSICIAN SERVICES
NPI 1477614105
Clinic/Center - Multi-Specialty in Lincoln, IL

Active since December 13, 2006CLIA 14D0435490 · Waiver
515 N COLLEGE ST, LINCOLN, IL 62656(217) 732-9681(217) 735-6527 Get Directions Write a Review

NPPES record last updated: January 16, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Memorial Physician Services NPPES

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

MEMORIAL PHYSICIAN SERVICES (NPI 1477614105) is a healthcare organization registered as a multi-specialty in Lincoln, Illinois and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Edgar J Curtis, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1477614105
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameMEMORIAL PHYSICIAN SERVICES
Location Address515 N COLLEGE STLincoln, IL 62656-1401
Mailing AddressPo Box 3428Springfield, IL 62708-3428 · (800) 577-5368 · Fax (217) 757-2021
Fax(217) 735-6527
Organization SubpartNo
Authorized OfficialEdgar J CurtisPresident And Ceo · (217) 788-3340
Enumeration DateDecember 13, 2006
Last NPPES UpdateJanuary 16, 2013
✔ NPI 1477614105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
515 N COLLEGE ST, Lincoln, IL 62656

Other Identifiers 1

Medicare OSCAR/certification143895IL

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Memorial Physician Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIllinoisEnrollment IDO20040223000454Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

150

Medicare enrollment records show 150 clinicians reassign Medicare billing to Memorial Physician Services, which bills Medicare for the services they deliver. Of these, 11 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 10

Nurse Practitioner93
Family Practice26
Psychiatry10
Internal Medicine7
Pediatric Medicine5
Mental Health Counselor4
Orthopedic Surgery2
Clinical Social Worker1
2 other specialties2

Nearest to this location (20)

See all 150
Nurse Practitioner
NPI 1528477015
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1144995812
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1780045229
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1235691809
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1770501595
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1386641033
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1265053417
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1467427716
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1750357422
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1881669158
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1972373041
515 N COLLEGE ST
Lincoln, IL 62656
(217) 732-9681
✔ PECOS✔ Accepts Medicare0.7 mi
Family Practice
NPI 1053750851
520 N FOURTH ST
Springfield, IL 62794
(217) 545-8000
✔ PECOS✔ Accepts Medicare21 mi
Nurse Practitioner
NPI 1376195818
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-7400
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1134791270
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-7400
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1699147215
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-2600
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1609486802
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-2600
✔ PECOS✔ Accepts Medicare24 mi
Family Practice
NPI 1013144021
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-7400
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1528769130
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-2600
✔ PECOS✔ Accepts Medicare24 mi
Nurse Practitioner
NPI 1790219459
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-2600
✔ PECOS✔ Accepts Medicare25 mi
Emergency Medicine
NPI 1972716033
3220 ATLANTA ST
Springfield, IL 62707
(217) 588-7400
✔ PECOS✔ Accepts Medicare25 mi
See all 150 clinicians

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 14D0435490

Memorial Physician Services - Lincoln · Lincoln, IL
Active · expires Apr 27, 2028
CLIA Number14D0435490
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorAmir John Wahab
Laboratory Phone(217) 732-9681
Laboratory LocationMemorial Physician Services - Lincoln515 North College Street, Lincoln, IL 62656
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Memorial Physician Services's NPI number?

The NPI number for Memorial Physician Services is 1477614105. It was assigned to this organization in the NPPES registry on December 13, 2006.

Where is Memorial Physician Services located?

Memorial Physician Services is located at 515 N College St, Lincoln, IL 62656. The listed phone number is (217) 732-9681.

What is Memorial Physician Services's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Memorial Physician Services enrolled in Medicare?

Yes. Memorial Physician Services is registered in the Medicare PECOS enrollment system.

When is Memorial Physician Services's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Memorial Physician Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 150 clinicians in 10 Medicare specialties reassign their Medicare billing to Memorial Physician Services. 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. The largest specialties are Nurse Practitioner (93), Family Practice (26) and Psychiatry (10). Of these, 11 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Memorial Physician Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0435490) is associated with this NPI, valid through April 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Memorial Physician Services was last updated on January 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.