MICHELLE LIDVALL CRNA
NPI 1659789410
Nurse Anesthetist, Certified Registered in Peoria, IL

Q: What is Michelle Lidvall's NPI number?

The NPI number for Michelle Lidvall is 1659789410. It was assigned to this individual provider in the NPPES registry on July 24, 2014.

Q: What is Michelle Lidvall's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Michelle Lidvall was last updated on December 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 July 24, 2014PECOS EnrolledAccepts Medicare Assignment

221 NE GLEN OAK AVE, PEORIA, IL 61636(309) 672-5522 Get Directions Write a Review

NPPES record last updated: December 29, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Michelle Lidvall Crna NPPES

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

MICHELLE LIDVALL CRNA (NPI 1659789410) is an individual nurse anesthetist, certified registered in Peoria, Illinois, licensed in Illinois (209.011831) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1659789410

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameMICHELLE LIDVALLCredential: CRNA

Location Address221 NE GLEN OAK AVEPeoria, IL 61636-0001

Mailing Address221 Ne Glen Oak AvePeoria, IL 61636-0001 · (309) 672-5522

Phone(309) 672-5522

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJuly 24, 2014

Last NPPES UpdateDecember 29, 2014

✔ NPI 1659789410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in IL · 209.011831

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered NurseTaxonomy 163W00000X · License 041385084 (IL)

221 NE GLEN OAK AVE, Peoria, IL 61636

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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

Michelle Lidvall Crna 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 ID1355666371

PECOS Enrollment IDI20150216001999

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 Michelle Lidvall reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Methodist Medical Center Of Illinois

Same address

General Acute Care Hospital

221 NE GLEN OAK AVE
Peoria, IL 61636

Reassigned Medicare billing, Illinois enrollment
67 clinicians in this Medicare group

NPI 1164474755 (309) 672-5522

Carle Health Medical Group

83 mi

Internal Medicine

611 W PARK ST
Urbana, IL 61801

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Carle Health Care Incorporated
2,516 clinicians in this Medicare group

NPI 1154653947 (217) 383-8300

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for lens surgery 00142

Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.

16 services16 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Proctor Hospital

Acute Care Hospitals · Peoria, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140013

Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County

Emergency services

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140209

Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61636 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

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.

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 Michelle Lidvall's NPI number?

The NPI number for Michelle Lidvall is 1659789410. It was assigned to this individual provider in the NPPES registry on July 24, 2014.

Where is Michelle Lidvall located?

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

What is Michelle Lidvall's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Michelle Lidvall enrolled in Medicare?

Yes. Michelle Lidvall 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 Michelle Lidvall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Lidvall reassigns Medicare benefits to 2 organizations: Methodist Medical Center Of Illinois (Peoria, IL) and Carle Health Medical Group (Urbana, IL). 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 Michelle Lidvall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Michelle Lidvall affiliated with any hospitals?

According to CMS data, Michelle Lidvall is affiliated with Proctor Hospital and Methodist Medical Center Of Illinois.

When was this NPI record last updated?

The NPPES record for Michelle Lidvall was last updated on December 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.