Jackson Graves, MD - Medicare Pediatrics in Peoria, IL

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Jackson Graves, MD is a medicare enrolled "Pediatrics" physician in Peoria, Illinois. His current practice location is 530 Ne Glen Oak Ave, Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 655-2000.

Jackson Graves is licensed to practice in Illinois (license number 036.162138) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1740843127.

Contact Information

Jackson Graves, MD
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001
(309) 655-2000
Not Available

Map and Direction




Physician's Profile

Full NameJackson Graves
GenderMale
SpecialityPediatrics
Location530 Ne Glen Oak Ave, Peoria, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1740843127
  • Provider Enumeration Date: 04/21/2019
  • Last Update Date: 02/28/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3476985573
  • Enrollment ID: I20230411002015

Medical Identifiers

Medical identifiers for Jackson Graves such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1740843127NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 036.162138 (Illinois)Secondary
208000000XPediatrics 036.162138 (Illinois)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jackson Graves allows following entities to bill medicare on his behalf.
Entity NameThe Board Of Trustees Of The University Of Illinois
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386863819
PECOS PAC ID: 3072422716
Enrollment ID: O20031112000158
Entity NameOsf Multi-specialty Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922445527
PECOS PAC ID: 3678889789
Enrollment ID: O20150904000279

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackson Graves is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jackson Graves, MD
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001

Ph: (217) 971-5748		Jackson Graves, MD
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001

Ph: (309) 655-2000

Reviews and Comments


Pediatrics Doctors in Peoria, IL

Thomas James Mcmorrow, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2553    Fax: 309-655-2602
Jessica Ford-davis, D.O.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2274    
Kelsey Elizabeth Grimes, DO
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2000    
Jessica N Mistretta, DO
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2000    
Mrs. Valeria Claudia Benavides Lopez, M.D., M.P.H.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-624-3313    
Khalid Al Katranji, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-7171    
Dr. Gretchen L Kopec, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-624-0615    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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