PEORIA EAR, NOSE AND THROAT GROUP, S.C.
NPI 1952380628
Otolaryngology in Peoria, IL
About Peoria Ear, Nose And Throat Group, S.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEORIA EAR, NOSE AND THROAT GROUP, S.C. (NPI 1952380628) is a healthcare organization registered as an otolaryngology in Peoria, Illinois and active in the NPI registry since January 2006. The organization lists Tyler Robertson, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peoria Ear, Nose And Throat Group, S.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Peoria Ear, Nose And Throat Group, S.C., which bills Medicare for the services they deliver. Of these, 12 practice at this address and 13 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (16)
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 Peoria Ear, Nose And Throat Group, S.C.'s NPI number?
The NPI number for Peoria Ear, Nose And Throat Group, S.C. is 1952380628. It was assigned to this organization in the NPPES registry on January 11, 2006.
Where is Peoria Ear, Nose And Throat Group, S.C. located?
Peoria Ear, Nose And Throat Group, S.C. is located at 7301 N Knoxville Ave, Peoria, IL 61614. The listed phone number is (309) 589-5900.
What is Peoria Ear, Nose And Throat Group, S.C.'s specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Peoria Ear, Nose And Throat Group, S.C. enrolled in Medicare?
Yes. Peoria Ear, Nose And Throat Group, S.C. is registered in the Medicare PECOS enrollment system.
When is Peoria Ear, Nose And Throat Group, S.C.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Peoria Ear, Nose And Throat Group, S.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 5 Medicare specialties reassign their Medicare billing to Peoria Ear, Nose And Throat Group, S.C.. 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 Qualified Audiologist (8), Otolaryngology (5) and Allergy/Immunology (1). Of these, 12 practice at this address and 13 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 Peoria Ear, Nose And Throat Group, S.C. was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days 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.
# Peoria Ear, Nose And Throat Group, S.c. · NPI 1952380628
Otolaryngology organization in Peoria, Illinois. Organization record, active in the CMS NPPES registry since January 11, 2006.
## Identity
- **NPI:** 1952380628 (Entity type: Organization)
- **Enumerated:** January 11, 2006
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **Organization subpart:** No
- **Authorized official:** Tyler Robertson, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 7301 N KNOXVILLE AVE, Peoria, IL 61614-2017
- **Phone:** (309) 589-5900 · **Fax:** (309) 689-0312
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Illinois, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 16 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Qualified Audiologist (8), Otolaryngology (5), Allergy/Immunology (1); 12 practice at this address and 13 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 17, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1952380628) · Data from the CMS NPPES public registry.