Advanced Surgical Technology, LLC
A Medicare group practice based in Centralia, IL: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 3274857685), with 10 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 3274857685
- Provider type
- Part A Provider - Rural Health Clinic, Part B Supplier - Clinic/Group Practice
- Enrolled in
- IL
- Enrollments
- 3
- Group size
- 7 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 6
Enrollment records 3
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20150113000768 | IL | Part B Supplier - Clinic/Group Practice | 1497159024 |
| O20230804002096 | IL | Part A Provider - Rural Health Clinic | 1659058659 |
| O20230816001125 | IL | Part A Provider - Rural Health Clinic | 1831876838 |
NPIs in this group 3
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Advanced Surgical Technology, LLC
- Surgery Physician
- Centralia, IL
- NPI 1497159024
-
Advanced Surgical Technology, LLC
- Rural Health Clinic/Center
- Hoyleton, IL
- NPI 1659058659
-
Advanced Surgical Technology, LLC
- Rural Health Clinic/Center
- Carlyle, IL
- NPI 1831876838
Practice locations
- Centralia, IL2
- Mount Vernon, IL1
- Herrin, IL1
- Hoyleton, IL1
- Carlyle, IL1
Clinicians 10
Clinicians who reassign their Medicare benefits to this group (10) or whom Care Compare lists as members (7).
-
Randy Dewain Balmforth, D.O.
- Diagnostic Radiology Physician
- Garden City, MI
- NPI 1366642738
-
Merrilee R Brandt, M.D.
- Surgery Physician
- Centralia, IL
- NPI 1942243811
-
Abbey Dempsey
- Nurse Practitioner
- Centralia, IL
- NPI 1104287598
-
Macey Gettinger
- Nurse Practitioner
- Mount Vernon, IL
- NPI 1912528126
-
Udaya K Liyanage, MD
- Surgery Physician
- Mount Vernon, IL
- NPI 1972548287
-
Kelsey Meyer, NP
- Family Nurse Practitioner
- Carlyle, IL
- NPI 1386304764
-
Kylie Margaret Newcomb
- Nurse Practitioner
- Centralia, IL
- NPI 1669334587
-
Jana Tull, APN
- Family Nurse Practitioner
- Centralia, IL
- NPI 1588105654
-
John Ryan Willis, MD
- Diagnostic Radiology Physician
- Mount Vernon, IL
- NPI 1326095670
-
Hisham T Youssef, MD RADIOLOGIST
- Diagnostic Radiology Physician
- Harrisburg, IL
- NPI 1720078629
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.