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DR. KRISTOPHER CARSON ROSBURG MD
NPI 1578829321
Pediatrics - Neonatal-Perinatal Medicine in Peoria, IL

Active since April 05, 2012PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 677-7171 Get Directions Write a Review

NPPES record last updated: October 12, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 12, 2020, Jul 10, 2019, Dec 7, 2015 (3 updates tracked since 2015).

About Dr. Kristopher Carson Rosburg Md NPPES

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

DR. KRISTOPHER CARSON ROSBURG MD (NPI 1578829321) is an individual neonatal-perinatal medicine provider in Peoria, Illinois, licensed in Illinois (036.149648) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578829321
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NameDR. KRISTOPHER CARSON ROSBURGCredential: MD
Location Address530 NE GLEN OAK AVEPeoria, IL 61637
Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001 · (309) 677-7171
Phone(309) 677-7171
Sole ProprietorNo
Enumeration DateApril 5, 2012
Last NPPES UpdateOctober 12, 20203 updates tracked since enumeration
NPPES CertifiedOctober 12, 2020
✔ NPI 1578829321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
License✔ Licensed in IL · 036.149648
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Also ListedPediatricsTaxonomy 208000000X · License 036.149648 (IL)
530 NE GLEN OAK AVE, Peoria, IL 61637
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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 (PECOS)

Dr. Kristopher Carson Rosburg Md 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 Reassignment

Medicare enrollment records show Kristopher Rosburg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Board Of Trustees Of The University Of Illinois
0.6 mi
Pediatrics
1 ILLINI DR
Peoria, IL 61605
  • Reassigned Medicare billing, Illinois enrollment
  • 2,127 clinicians in this Medicare group
NPI 1467425322 (309) 680-8649

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

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
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710
DR. JAMES DANIEL DEWAR D.O.
Internal Medicine (Interventional Cardiology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-7257

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 Kristopher Rosburg's NPI number?

The NPI number for Kristopher Rosburg is 1578829321. It was assigned to this individual provider in the NPPES registry on April 5, 2012.

Where is Kristopher Rosburg located?

Kristopher Rosburg practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 677-7171.

What is Kristopher Rosburg's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Kristopher Rosburg enrolled in Medicare?

Yes. Kristopher Rosburg is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kristopher Rosburg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristopher Rosburg reassigns Medicare benefits to Board Of Trustees Of The University Of Illinois (Peoria, IL). The 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 Kristopher Rosburg'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 Kristopher Rosburg was last updated on October 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.