DR. JACOB ALEXANDER RESHETAR MD
NPI 1780326652
Emergency Medicine in Peoria, IL

Q: What is Jacob Reshetar's NPI number?

The NPI number for Jacob Reshetar is 1780326652. It was assigned to this individual provider in the NPPES registry on April 11, 2022.

Q: What is Jacob Reshetar's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Reshetar was last updated on March 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since April 11, 2022PECOS EnrolledAccepts Medicare Assignment

530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: March 17, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 17, 2026, Apr 11, 2022 (2 updates tracked since 2022).

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About Dr. Jacob Alexander Reshetar Md NPPES

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

DR. JACOB ALEXANDER RESHETAR MD (NPI 1780326652) is an individual emergency medicine provider in Peoria, Illinois, licensed in Arizona (74729) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1780326652

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDR. JACOB ALEXANDER RESHETARCredential: MD

Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001

Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001

Phone(309) 655-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 11, 2022

Last NPPES UpdateMarch 17, 20262 updates tracked since enumeration

NPPES CertifiedMarch 17, 2026

✔ NPI 1780326652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in AZ · 74729

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

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 and accepts Medicare assignment

Dr. Jacob Alexander Reshetar Md 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 ID2961984752

PECOS Enrollment IDI20260302001993

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

Arizona Acute Medical Services 1 PC

1,332 mi

Hospitalist

1930 E THOMAS RD
Phoenix, AZ 85016

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

NPI 1154860674 (602) 532-1000

Emergency Group Of Arizona Professional Corporation

1,333 mi

Emergency Medicine

2000 W BETHANY HOME RD
Phoenix, AZ 85015

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

NPI 1215275433 (925) 924-1600

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