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Deactivated NPI 1003818451 Deactivated / Inactive NPI Male Practitioner

Dr. Fred Erik Braastad , MD

Specialist • Peoria, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Fred Braastad has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 15, 2005
NPI Deactivation Date August 06, 2019
Total Practice Duration ~14 Years of Practice (2005 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Fred Braastad, MD was a registered Specialist practicing in Peoria, IL. Throughout an active medical career spanning 14 years, Dr. Braastad provided care at the practice location at 7303 N KNOXVILLE AVE until profile deactivation on 2019-08-06.

Historical Medicare Part B clinical services included new patient outpatient office visit, established patient outpatient office visit, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

7303 N Knoxville Ave

Peoria, IL 616142017

Telephone 3096914005
Fax 3096916144
Associated Practice Facility / Clinic
🏢 Associated Surgical Group, Sc Facility NPI 1336255124

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 27.0 Yrs
State Avg: 38.5 Yrs
Regional Practice Density
20 Specialists

Practicing in Peoria, IL (1322 Statewide)

Telehealth Adoption Rate
5.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
57.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
39 39 $241.00 $103.49
99213 Established patient office or other outpatient visit, typically 15 minutes
29 28 $152.00 $71.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
16 14 $97.00 $43.27
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
12 12 $368.00 $150.99
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
12 12 $337.00 $135.45

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License IL 036-074256

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
NPI 1174552681

Doctor of Medicine (M.D.)

Jayme Phillips , PA-C

Physician Assistant

NPI 1316331408

Physician Assistant (Certified)

NPI 1376906446

Doctor of Medicine (M.D.)

NPI 1386087518

Doctor of Medicine (M.D.)

Laura Brown

Surgery - Surgical Critical Care

NPI 1699938316
NPI 1821080078

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 06, 2019

Record deactivated on August 06, 2019

NPI Profile Active March 07, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location March 07, 2016

Registered at 7303 N KNOXVILLE AVE, PEORIA, IL 616142017 (Tel: 3096914005)

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Updated Business Mailing Address March 07, 2016

Registered at 7303 N KNOXVILLE AVE, PEORIA, IL 616142017 (Tel: 3096914005)

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Provider Name / Credentials Updated March 07, 2016

Recorded as FRED BRAASTAD, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2016

Specialist (License #036-074256 in IL)

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Initial NPI Registration & Enumeration August 15, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003818451
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 15, 2005
Last Update: March 07, 2016
Deactivation Date: August 06, 2019

Mailing Address

7303 N Knoxville Ave

Peoria, IL 616142017

Phone: 3096914005

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.