DR. SHANE RAINEY D.O.
NPI 1588041164
Pediatrics in Peoria, IL

Q: What is Shane Rainey's NPI number?

The NPI number for Shane Rainey is 1588041164. It was assigned to this individual provider in the NPPES registry on May 2, 2015.

Q: What is Shane Rainey's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Rainey was last updated on January 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since May 02, 2015PECOS Enrolled

530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2274 Get Directions Write a Review

NPPES record last updated: January 7, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Shane Rainey D.o. NPPES

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

DR. SHANE RAINEY D.O. (NPI 1588041164) is an individual pediatrics provider in Peoria, Illinois, licensed in Illinois (036.144466) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588041164

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. SHANE RAINEYCredential: D.O.

Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001

Mailing Address4005 W Carrousel LnPeoria, IL 61615-2860 · (630) 882-5719

Phone(309) 655-2274

Sole ProprietorYes

Enumeration DateMay 2, 2015

Last NPPES UpdateJanuary 7, 2019

✔ NPI 1588041164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in IL · 036.144466

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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. Shane Rainey D.o. 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 Reassignments

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

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

Banner Hospital Based Physicians West LLC

875 mi

Multi-Specialty

1233 E 2ND ST
Casper, WY 82601

Reassigned Medicare billing, Wyoming enrollment
54 clinicians in this Medicare group

NPI 1619464120 (307) 577-2171

Banner-University Medical Group

1,316 mi

Nutrition, Education

535 N WILMOT RD STE 101
Tucson, AZ 85711

Reassigned Medicare billing, Arizona enrollment
1,514 clinicians in this Medicare group

NPI 1932708328 (520) 694-5437

Banner Physician Super Specialists Arizona LLC

1,316 mi

Multi-Specialty

37100 N GANTZEL RD STE 214
San Tan Valley, AZ 85140

Reassigned Medicare billing, Arizona enrollment
188 clinicians in this Medicare group

NPI 1396014403 (480) 412-9400

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 61637 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. 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