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PREMIER MEDICAL GROUP, LLC
NPI 1942501978
Surgery in Bloomington, IL

Active since November 08, 2010
1401 EASTLAND DR STE B, BLOOMINGTON, IL 61701(309) 451-1123(309) 451-1212 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Premier Medical Group, Llc NPPES

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

PREMIER MEDICAL GROUP, LLC (NPI 1942501978) is a healthcare organization registered as a surgery in Bloomington, Illinois and active in the NPI registry since November 2010. The organization lists Phil Arthur Mcgowan, Administrator, as its authorized official.

NPPES Registry Identity

NPI1942501978
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NamePREMIER MEDICAL GROUP, LLC
Location Address1401 EASTLAND DR STE BBloomington, IL 61701-3553
Mailing Address1401 Eastland Dr Ste BBloomington, IL 61701-3553 · (309) 451-1123 · Fax (309) 451-1212
Phone(309) 451-1123
Fax(309) 451-1212
Organization SubpartNo
Authorized OfficialPhil Arthur McgowanAdministrator · (309) 451-1123
Enumeration DateNovember 8, 2010
Last NPPES UpdateDecember 8, 2023
NPPES CertifiedDecember 8, 2023
✔ NPI 1942501978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedPlastic SurgeryTaxonomy 208200000X
Also ListedUrologyTaxonomy 208800000X
Also ListedNurse Anesthetist, Certified RegisteredTaxonomy 367500000X
1401 EASTLAND DR STE B, Bloomington, IL 61701
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premier Medical Group, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Premier Medical Group, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 10 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 5

Nurse Practitioner4
Urology4
Certified Registered Nurse Anesthetist (CRNA)2
Gastroenterology1
Pathology1

Clinicians, nearest first (12)

Vicken Chalian, M.D.
Urology
NPI 1871529594
1401 EASTLAND DR SUITE B
Bloomington, IL 61701
(309) 663-9424
✔ PECOS✔ Accepts MedicareSame address
Anastasia Kovalaske, NP
Nurse Practitioner
NPI 1790118586
1401 EASTLAND DR SUITE B
Bloomington, IL 61761
(309) 663-9424
✔ PECOS✔ Accepts MedicareSame address
Benjamin Leak, M.D.
Urology
NPI 1043248867
1401 EASTLAND DR SUITE B
Bloomington, IL 61701
(309) 663-9424
✔ PECOS✔ Accepts MedicareSame address
Justin Couch, NP-C
Nurse Practitioner
NPI 1922451681
2200 E WASHINGTON ST
Bloomington, IL 61701
(309) 662-3311
✔ PECOS✔ Accepts Medicare0.2 mi
Renuka Bhaskar, MD
Pathology
NPI 1235163056
105 KRISPY KREME DR STE 4
Bloomington, IL 61704
(309) 585-2837
✔ PECOS✔ Accepts Medicare0.5 mi
Alan Glatz, N.P.
Nurse Practitioner
NPI 1417187659
1701 E COLLEGE AVE
Bloomington, IL 61704
(309) 664-3160
✔ PECOS✔ Accepts Medicare1.9 mi
Jennifer Frazier, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1780612812
2200 JACOBSSEN DR STE B
Normal, IL 61761
(309) 451-1123
✔ PECOS✔ Accepts Medicare2.8 mi
Roy Haynes, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1174636989
2200 JACOBSSEN DR STE B
Normal, IL 61761
(309) 451-1123
✔ PECOS✔ Accepts Medicare2.8 mi
Summer Hinthorne, APN, WHNP
Nurse Practitioner
NPI 1831416189
2200 JACOBSSEN DR STE B
Normal, IL 61761
(309) 451-1123
✔ PECOS✔ Accepts Medicare2.8 mi
Stephen Matter, M.D.
Gastroenterology
NPI 1134228224
2200 JACOBSSEN DR
Normal, IL 61761
(309) 451-1123
✔ PECOS✔ Accepts Medicare2.8 mi
Salvatore Catarinicchia, M.D.
Urology
NPI 1912240466
13001 E 17TH PL UNIVERSITY OF COLORADO SCHOOLF OF MEDICINE GME
Aurora, CO 80045
(303) 724-2715
✔ PECOS✔ Accepts Medicare841 mi
Scott Morgan, M.D.
Urology
NPI 1679547947
10000 W COLONIAL DR STE 285
Ocoee, FL 34761
(407) 298-6950
✔ PECOS✔ Accepts Medicare925 mi

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 Premier Medical Group, LLC's NPI number?

The NPI number for Premier Medical Group, LLC is 1942501978. It was assigned to this organization in the NPPES registry on November 8, 2010.

Where is Premier Medical Group, LLC located?

Premier Medical Group, LLC is located at 1401 Eastland Dr Ste B, Bloomington, IL 61701. The listed phone number is (309) 451-1123.

What is Premier Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Premier Medical Group, LLC enrolled in Medicare?

Yes. Premier Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premier Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 5 Medicare specialties reassign their Medicare billing to Premier Medical Group, LLC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (4), Urology (4) and Certified Registered Nurse Anesthetist (CRNA) (2). Of these, 3 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premier Medical Group, LLC was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.