Individual provider Active NPI

Cesar E Coello, M.D.

  • Cardiovascular Disease Physician
  • Carbondale, IL
National Provider Identifier
1003997560
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036089777 Issued in IL
Practice address
409 W Oak St
Carbondale, IL 62901-1414
Phone
(618) 529-4455
Fax
(618) 351-1287
NPI assigned
Oct 18, 2006
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-089777 IL
Cardiovascular Disease Physician 207RC0000X 036089777 IL Primary

Addresses

Primary practice location

409 W Oak St
Carbondale, IL 62901-1414

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455

Other practice location 2

3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455

Other identifiers 2

IdentifierTypeStateIssuer
036089777MedicaidIL
060054049OtherILRAILROAD

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ccoello13928@sih.direct-ci.com
Direct Messaging Address ccoello13928@sih.direct-ci.com
Direct Messaging Address ccoello13928@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000328 IL Practitioner - Cardiovascular Disease (Cardiology) 5698716488 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

409 W Oak St
Carbondale, IL 62901-1414
Phone (618) 529-4455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-089777ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Hospital District CurrentSince Jun 11, 2009 Accepting new patients
Franklin Hospital District CurrentSince Jun 11, 2009 Accepting new patients
Southern Illinois Hospital Services CurrentSince Apr 1, 2005 Accepting new patients
Harrisburg Medical Center Inc CurrentSince Jan 17, 2024 Accepting new patients
Southern Illinois Hospital Services Current Accepting new patients
Southern Illinois Hospital Services CurrentSince Apr 1, 2005 Accepting new patients
Franklin Hospital District Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Mar 1, 2012 Accepting new patients
Prairie Cardiovascular Consultants LTD Cardiovascular Disease CurrentSince Jul 5, 1999 Accepting new patients
Prairie Cardiovascular Consultants LTD Specialist Past Accepting new patients

Locations

201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113

1239 E Main St
Carbondale, IL 62901

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

217 S Park Ave
Ste 2
Herrin, IL 62948

3106 Outer Dr
Marion, IL 62959
Phone (618) 997-4332

3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

5383 State Route 154
Pinckneyville, IL 62274
Phone (618) 357-2131

619 E Mason St
#4P57
Springfield, IL 62701

Networks

  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/c680de42-53d4-410c-a755-e5a226565d34

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1003997560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011414",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S Park Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483611",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 W Ernestine Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595800",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COELLO",
        "first_name": "CESAR",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-089777",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036089777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089777",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "060054049",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccoello13928@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "217 S Park Ave Ste 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccoello13928@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccoello13928@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3905 W Ernestine Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.