1. Home
  2. Directory
  3. Illinois
  4. Peoria
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

FLETCHER SUMMA MD
NPI 1619762598
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since April 11, 2025PECOS Enrolled
221 NE GLEN OAK AVE, PEORIA, IL 61636(309) 672-5522 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fletcher Summa Md NPPES

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

FLETCHER SUMMA MD (NPI 1619762598) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619762598
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameFLETCHER SUMMACredential: MD
Location Address221 NE GLEN OAK AVEPeoria, IL 61636-0001
Mailing Address1919 W Sherman AveWest Peoria, IL 61604-5642
Phone(309) 672-5522
Sole ProprietorYes
Enumeration DateApril 11, 2025
NPPES CertifiedApril 6, 2025
✔ NPI 1619762598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
221 NE GLEN OAK AVE, Peoria, IL 61636
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fletcher Summa 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.

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.

BRYCE HAMAMOTO
Student in an Organized Health Care Education/Training Program
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
RIAZ SHAH MD
Internal Medicine
221 NE GLEN OAK AVE, SUITE 504
PEORIA, IL 61636
Peoria County (309) 672-5729
CENTRAL ILLINOIS RADIATION ONCOLOGY PHYSICIANS, LTD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5700
MIHAILO NIKOLIC
Nurse Anesthetist, Certified Registered
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5654
WAQAS ALI MD
Internal Medicine
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
ANNE LOOK APN
Nurse Practitioner (Acute Care)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
DR. KENNETH STRUM M.D.
Anesthesiology
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 369-1761
DR. ANDREW BRIAN ARMSTRONG M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-4920

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 Fletcher Summa's NPI number?

The NPI number for Fletcher Summa is 1619762598. It was assigned to this individual provider in the NPPES registry on April 11, 2025.

Where is Fletcher Summa located?

Fletcher Summa practices at 221 NE Glen Oak Ave, Peoria, IL 61636. The listed phone number is (309) 672-5522.

What is Fletcher Summa's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Fletcher Summa enrolled in Medicare?

Yes. Fletcher Summa is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Fletcher Summa was last updated on April 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.