Marcus Mutidjo, APN
NPI 1063825446 · Family Nurse Practitioner · Peoria, IL
Enrolled with Medicare as Order and Referring Only - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Marcus Mutidjo, APN is a Family Nurse Practitioner provider in Peoria, IL (NPI 1063825446).
Provider details
- NPI number
- 1063825446
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APN
- Sex
- Male
- Sole proprietor
- No
- License
- 209016806 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.
| Drug | Part D claims (2024) |
|---|---|
| Emtricitabine/Tenofov Alafenambrand: Descovy | 16 |
| Emtricitabine/Tenofovir (tdf)brand: Emtricitabine-Tenofovir Disop | 12 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-06-03
- Last updated
- 2019-01-14
Frequently asked questions
- What is Marcus Mutidjo's NPI number?
- Marcus Mutidjo's National Provider Identifier (NPI) is 1063825446, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Marcus Mutidjo's specialty?
- Marcus Mutidjo is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Marcus Mutidjo located?
- Marcus Mutidjo's practice location on file with NPPES is 1701 W Garden St, Peoria, IL 61605.
- What is Marcus Mutidjo's phone number?
- The practice phone number listed in the NPPES registry for Marcus Mutidjo is (309) 680-7600.
- Does Marcus Mutidjo accept Medicare?
- Marcus Mutidjo is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Marcus Mutidjo's NPI active?
- Yes — Marcus Mutidjo's NPI (1063825446) is active in the NPPES registry as of the last update on 2019-01-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.