Stuart H Berryman (NPI# 1093774705, PAC ID# 1759470529) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1093774705 |
| PAC ID by PECOS | 1759470529 |
| Professional Enrollment ID | I20071130000507 |
| Full Name | Stuart H Berryman |
| Organization Legal Name | SODERSTROM DERMATOLOGY CENTER S C |
| Address |
2200 Marquette Rd Peru IL 61354-1547 |
| Phone Number | 8152247400 |
| Gender | M |
| Graduation Year | 2002 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2062432651 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 | 3096747546 | SODERSTROM DERMATOLOGY CENTER S C |
| 2200 Marquette Rd, Peru, IL 61354-1547 | 8152247400 | SODERSTROM DERMATOLOGY CENTER S C |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_047_overall | Care Plan | 3% | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 59% | |
| MIPS_EC_138_overall | Melanoma: Coordination of Care | 56% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 98% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 81% | |
| MIPS_EC_431_overall | Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 82% |
| Organization Legal Name | SODERSTROM DERMATOLOGY CENTER S C |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nour Almardini | Pathology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| James M Jeffries Iii | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 60 S Soangetaha Rd, Galesburg, IL 61401-7524 |
| Carl W Soderstrom Jr. | Dermatology | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Carissa L Pardekooper | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Joy M Watson | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Chen Wang | Pathology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Jennifer G Tomelden | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| John E Lomax | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Michelle L Roth | Physician Assistant | Soderstrom Dermatology Center S C | 60 S Soangetaha Rd, Galesburg, IL 61401-7524 |
| Katherine E Shindelar | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Street Address |
2200 MARQUETTE RD |
| City | PERU |
| State | IL |
| Zip | 61354-1547 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer G Tomelden | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| Stephanie M Ellis | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| Sondra Lanelle Blocki | Physical Therapy | 2200 Marquette Rd, Suite 111, Peru, IL 61354-1569 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dotun I Oyedijo | Radiation Oncology | 4391 Venture Dr, Peru, IL 61354-1018 | |
| Joseph B Jackson | Optometry | Jak Enterprises Inc | 3323 Frontage Rd, Peru, IL 61354-1101 |
| David J Coynik | Dermatology | David J Coynik, Md,pc | 4413 Progress Blvd, Peru, IL 61354-1109 |
| Dale R Chilson | Otolaryngology | St. Margarets Hospital | 4040 Progress Blvd, Peru, IL 61354-1124 |
| Katrina Mcquilkin | Chiropractic | 3815 Progress Blvd, Suite C, Peru, IL 61354-1188 | |
| Bulent Mamikoglu | Otolaryngology | 4231 Progress Blvd, Suite 2, Peru, IL 61354-1193 | |
| Rakesh K Garg | Neurology | 4231 Progress Blvd, Peru, IL 61354-1193 | |
| Angela Benavides | Neurology | St. Margarets Hospital | 1400 Midtown Plaza, Peru, IL 61354-1269 |
| Lacey M Strack | Physician Assistant | St. Margarets Hospital | 1650 Midtown Rd, Peru, IL 61354-1274 |
| Rachel L Colby | Physician Assistant | St. Margarets Hospital | 1650 Midtown Rd, Peru, IL 61354-1274 |
| Find all physicians in zip 61354 | |||
| City | PERU |
| Zip Code | 61354 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PERU + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.