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ALYSSA WILLIAMS BLAKE
NPI 1740063148
Nurse Practitioner - Acute Care in Peoria, IL

Active since August 17, 2023PECOS Enrolled
3626 N SHERIDAN RD, PEORIA, IL 61604(309) 308-5100 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Alyssa Williams Blake NPPES

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

ALYSSA WILLIAMS BLAKE (NPI 1740063148) is an individual acute care provider in Peoria, Illinois, licensed in Illinois (209030189) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740063148
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameALYSSA WILLIAMS BLAKE
Location Address3626 N SHERIDAN RDPeoria, IL 61604-1401
Mailing Address3626 N Sheridan RdPeoria, IL 61604-1401 · (309) 308-5100
Phone(309) 308-5100
Sole ProprietorNo
Enumeration DateAugust 17, 2023
Last NPPES UpdateOctober 30, 2024
NPPES CertifiedOctober 30, 2024
✔ NPI 1740063148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in IL · 209030189
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3626 N SHERIDAN RD, Peoria, IL 61604
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alyssa Williams Blake 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61604 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 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OSF MULTI-SPECIALTY GROUP
Non-Pharmacy Dispensing Site
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100
ANDREA N MACHNACKI APRN, CNP
Nurse Practitioner (Family)
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100
MELISSA M THEOBALD FNP
Nurse Practitioner (Family)
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100
MRS. TIFFANY ASHBY-FUNCHES APN, FNP-BC
Nurse Practitioner (Family)
3626 N SHERIDAN RD
PEORIA, IL 61604
Peoria County (309) 308-5100

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 Alyssa Williams Blake's NPI number?

The NPI number for Alyssa Williams Blake is 1740063148. It was assigned to this individual provider in the NPPES registry on August 17, 2023.

Where is Alyssa Williams Blake located?

Alyssa Williams Blake practices at 3626 N Sheridan Rd, Peoria, IL 61604. The listed phone number is (309) 308-5100.

What is Alyssa Williams Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Alyssa Williams Blake enrolled in Medicare?

Yes. Alyssa Williams Blake is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alyssa Williams Blake was last updated on October 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.