Mrs Lissa J Diefendorf, APN - Medicare Clinical Nurse Specialist in Peoria, IL

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Mrs Lissa J Diefendorf, APN is a medicare enrolled "Clinical Nurse Specialist - Adult Health" in Peoria, Illinois. Her current practice location is 403 W Corrington Ave, Peoria, Illinois. You can reach out to her office (for appointments etc.) via phone at (309) 222-5736.

Mrs Lissa J Diefendorf is licensed to practice in Illinois (license number 209008169) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1427356336.

Contact Information

Mrs Lissa J Diefendorf, APN
403 W Corrington Ave,
Peoria, IL 61604-2803
(309) 222-5736
Not Available

Map and Direction




Provider's Profile

Full NameMrs Lissa J Diefendorf
GenderFemale
SpecialityClinical Nurse Specialist - Adult Health
Location403 W Corrington 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: 1427356336
  • Provider Enumeration Date: 03/02/2011
  • Last Update Date: 03/02/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 5890948913
  • Enrollment ID: I20130123000206

Medical Identifiers

Medical identifiers for Mrs Lissa J Diefendorf such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427356336NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SA2200XClinical Nurse Specialist - Adult Health 209008169 (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. Mrs Lissa J Diefendorf allows following entities to bill medicare on her behalf.
Entity NameMark C Baylor
Entity TypePractitioner - Family Practice
Entity IdentifiersNPI Number: 1740256700
PECOS PAC ID: 8224021753
Enrollment ID: I20040408000392
Entity NameProctor Health Systems
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134173917
PECOS PAC ID: 3476440173
Enrollment ID: O20040227000906
Entity NameBelcrest Services Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245275312
PECOS PAC ID: 9335037217
Enrollment ID: O20040310001103
Entity NameMethodist Medical Center Of Illinois
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184670663
PECOS PAC ID: 1355259714
Enrollment ID: O20040315000196

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. Mrs Lissa J Diefendorf 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
Mrs Lissa J Diefendorf, APN
403 W Corrington Ave,
Peoria, IL 61604-2803

Ph: (309) 222-5736		Mrs Lissa J Diefendorf, APN
403 W Corrington Ave,
Peoria, IL 61604-2803

Ph: (309) 222-5736

Reviews and Comments


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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.

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