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PRINCE OSAZUWA EHIMAMIEGHO MD
NPI 1497499719
Family Medicine in Peoria, IL

Active since April 22, 2022PECOS EnrolledAccepts Medicare Assignment
815 MAIN ST STE C, PEORIA, IL 61602(309) 672-4977 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 14, 2025, Nov 6, 2025, Apr 22, 2022 (3 updates tracked since 2022).

About Prince Osazuwa Ehimamiegho Md NPPES

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

PRINCE OSAZUWA EHIMAMIEGHO MD (NPI 1497499719) is an individual family medicine provider in Peoria, Illinois, licensed in California (A202757) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1497499719
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePRINCE OSAZUWA EHIMAMIEGHOCredential: MD
Location Address815 MAIN ST STE CPeoria, IL 61602-1080
Mailing Address9466 Mourverde CtElk Grove, CA 95624-4611
Phone(309) 672-4977
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 22, 2022
Last NPPES UpdateNovember 14, 20253 updates tracked since enumeration
NPPES CertifiedNovember 14, 2025
✔ NPI 1497499719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in CA · A202757✔ Licensed in IL · 036172524
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.
815 MAIN ST STE C, Peoria, IL 61602
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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

Prince Osazuwa Ehimamiegho 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 ID42725764
PECOS Enrollment IDI20250822000861
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

3

Medicare enrollment records show Prince Ehimamiegho reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Methodist Medical Center Of Illinois
0.2 mi
Family Medicine
120 NE GLEN OAK AVE, SUITE 101
Peoria, IL 61603
  • Reassigned Medicare billing, Illinois enrollment
  • 693 clinicians in this Medicare group
NPI 1184670663 (309) 671-8230
Northbay Healthcare Group
1,726 mi
General Acute Care Hospital
1000 NUT TREE RD
Vacaville, CA 95687
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Northbay Physicians Surgery Center, LLC
  • 516 clinicians in this Medicare group
NPI 1255483202 (707) 646-3401
Northbay Health Medical Foundation
1,738 mi
Internal Medicine
4500 BUSINESS CENTER DR
Fairfield, CA 94534
  • Reassigned Medicare billing, California enrollment
  • 225 clinicians in this Medicare group
NPI 1760283527 (707) 646-3110

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 61602 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.

DR. THOMAS TSZ HIM CHOW DO
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
KYLE COTNER MD
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
DEMI CASTELLANOS
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
PATRECE ANTOINETTE BARKER D.O., M.S.
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4986
PAIGE ELIZABETH BONNER DO
Student in an Organized Health Care Education/Training Program
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
JEFFREY S. LEMAN MD
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
DR. KRISHNA SASANKA BATHINA MD
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4977
RIDA MOHAMMAD GAREEB MD
Family Medicine
815 MAIN ST STE C
PEORIA, IL 61602
Peoria County (309) 672-4986

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 Prince Ehimamiegho's NPI number?

The NPI number for Prince Ehimamiegho is 1497499719. It was assigned to this individual provider in the NPPES registry on April 22, 2022.

Where is Prince Ehimamiegho located?

Prince Ehimamiegho practices at 815 Main St Ste C, Peoria, IL 61602. The listed phone number is (309) 672-4977.

What is Prince Ehimamiegho's specialty?

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

Is Prince Ehimamiegho enrolled in Medicare?

Yes. Prince Ehimamiegho 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 Prince Ehimamiegho's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prince Ehimamiegho reassigns Medicare benefits to 3 organizations: Methodist Medical Center Of Illinois (Peoria, IL), Northbay Healthcare Group (Vacaville, CA) and Northbay Health Medical Foundation (Fairfield, CA). 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 Prince Ehimamiegho'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 Prince Ehimamiegho was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.