Doctor profile · Federal record

Dr. Tamarra Subyantoro, APN

Family Nurse Practitioner (CMS: Nurse Practitioner) · Nurse Practitioner · Peoria, IL

  • NPI 1942842018
  • Accepts Medicare
  • 7 yrs in practice
  • Female
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
5114 N Glen Park Place RD Ste 110
Peoria, IL 616144686
(309) 683-5600
fax (309) 683-5607

Credentials & registration

NPPES · NUCC
NPI registered
October 2019 — 7 yrs on file
Profile last updated
September 27, 2024
Year of graduation
2019 — 7 yrs since
Specialty taxonomy
363LF0000X — NUCC code
State license (1)
Illinois #209019900

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1942842018. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
397
Distinct HCPCS
5
Medicare allowed
$27,572
HCPCS Description Services Patients Avg allowed
99213 Established patient office or other outpatient visit, 20-29 minutes 202 197 $74
99214 Established patient office or other outpatient visit, 30-39 minutes 115 115 $104
81002 Urinalysis, manual test 58 56 $3
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 11 11 $30
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 11 11 $16

In context: peer comparison

Among 56 peers in this city , average services per provider: 65. This provider delivers 6.1× the peer median.

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
244
Patients
236
Total drug cost
$2,530
Drug Type Claims Patients Total cost
Prednisone Generic 75 74 $204
Cephalexin Generic 67 63 $810
Albuterol Sulfate Hfa (Albuterol Sulfate) Brand 26 25 $970
Mupirocin Generic 25 23 $200
Azithromycin Generic 22 22 $130
Doxycycline Hyclate Generic 15 15 $125
Amoxicillin-Clavulanate Potass (Amoxicillin/Potassium Clav) Brand 14 14 $90

Hospital affiliations

CMS Hospital Compare

Frequently asked questions

Auto-generated from federal data
What is Dr. Tamarra Subyantoro's medical specialty?
Dr. Tamarra Subyantoro practices Family Nurse Practitioner in Peoria, IL.
Where does Dr. Tamarra Subyantoro practice?
Dr. Tamarra Subyantoro practices at 5114 N Glen Park Place RD Ste 110, Peoria, IL 616144686. Office phone: 3096835600.
What is Dr. Tamarra Subyantoro's NPI?
Dr. Tamarra Subyantoro's National Provider Identifier (NPI) is 1942842018, issued by NPPES.
Does Dr. Tamarra Subyantoro accept Medicare assignment?
Yes. Dr. Tamarra Subyantoro accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Tamarra Subyantoro commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99213); Established patient office or other outpatient visit (HCPCS 99214); Urinalysis, manual test (HCPCS 81002). Source: CMS Medicare Physician & Other Practitioners file.