WILLIAM G NULTY MD
NPI 1639148356
Pediatrics - Adolescent Medicine in Peoria, IL
About William G Nulty Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLIAM G NULTY MD (NPI 1639148356) is an individual adolescent medicine provider in Peoria, Illinois and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
William G Nulty Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show William Nulty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Peoria, IL 61605
- Reassigned Medicare billing, Illinois enrollment
- 2,127 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 William Nulty's NPI number?
The NPI number for William Nulty is 1639148356. It was assigned to this individual provider in the NPPES registry on March 15, 2006.
Where is William Nulty located?
William Nulty practices at One Illini Dr Medical Service Plan, Peoria, IL 61605. The listed phone number is (309) 671-8503.
What is William Nulty's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.
Is William Nulty enrolled in Medicare?
Yes. William Nulty is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for William Nulty's services?
According to the CMS Revalidation Reassignment List (October 2026 release), William Nulty 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 William Nulty'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 William Nulty was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# William G Nulty, MD · NPI 1639148356
Adolescent Medicine physician in Peoria, Illinois. Individual provider, active in the CMS NPPES registry since March 15, 2006.
## Identity
- **NPI:** 1639148356 (Entity type: Individual)
- **Enumerated:** March 15, 2006
- **Primary specialty:** Pediatrics - Adolescent Medicine · taxonomy 2080A0000X
- **Sole proprietor:** No
## Practice location
- **Address:** ONE ILLINI DR, MEDICAL SERVICE PLAN, Peoria, IL 61605
- **Phone:** (309) 671-8503
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Board Of Trustees Of The University Of Illinois (NPI 1467425322, Peoria, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2007
- **Other identifiers:** Other IL01DC (IL); Other 07215036 (IL); Medicare UPIN F83738 (IL); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1639148356) · Data from the CMS NPPES public registry.