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ETHAN SPERRY
NPI 1861371635
Nurse Practitioner - Family in Peoria, IL

Active since August 27, 2025PECOS EnrolledAccepts Medicare Assignment
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: August 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ethan Sperry NPPES

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

ETHAN SPERRY (NPI 1861371635) is an individual family provider in Peoria, Illinois, licensed in Illinois (209-033064) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1861371635
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameETHAN SPERRY
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address203 Pine CirEureka, IL 61530-1639 · (309) 361-1687
Phone(309) 655-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 27, 2025
NPPES CertifiedAugust 27, 2025
✔ NPI 1861371635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209-033064
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

Ethan Sperry 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 ID9537665500
PECOS Enrollment IDI20250930002133
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 Reassignment

Medicare enrollment records show Ethan Sperry reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Osf Multi-Specialty Group
7.4 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1922445527 (309) 683-5050

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

Hospital Affiliations CMS Care Compare 2

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

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140064
Location3333 North SeminaryGalesburg, IL 61401 · Knox County
Emergency services Birthing friendly

Saint James Hospital

Acute Care Hospitals · Pontiac, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140161
Location2500 West Reynolds StreetPontiac, IL 61764 · Livingston County
Birthing friendly

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
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710
DR. JAMES DANIEL DEWAR D.O.
Internal Medicine (Interventional Cardiology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-7257

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 Ethan Sperry's NPI number?

The NPI number for Ethan Sperry is 1861371635. It was assigned to this individual provider in the NPPES registry on August 27, 2025.

Where is Ethan Sperry located?

Ethan Sperry practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2000.

What is Ethan Sperry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ethan Sperry enrolled in Medicare?

Yes. Ethan Sperry 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 organization bills Medicare for Ethan Sperry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Sperry reassigns Medicare benefits to Osf Multi-Specialty Group (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 Ethan Sperry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Ethan Sperry affiliated with any hospitals?

According to CMS data, Ethan Sperry is affiliated with St Mary Medical Center and Saint James Hospital.

When was this NPI record last updated?

The NPPES record for Ethan Sperry was last updated on August 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.