Individual provider Active NPI

Christine Celeste Kancius, DPM

  • Podiatrist
  • Morton, IL
National Provider Identifier
1013928365
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Practice address
1945 S Main St
Morton, IL 61550
Phone
(309) 263-1017
Fax
(309) 266-5864
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X IL Primary

Addresses

Primary practice location

1945 S Main St
Morton, IL 61550

Mailing address

3827 N Prospect Rd
Peoria, IL 61616
Phone (309) 686-1000

Other identifiers 1

IdentifierTypeStateIssuer
DA0891OtherILPALMETTO GBA- RAILROAD ME

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000814 IL Practitioner - Podiatry 7214016344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Podiatry Group, PCGroup PAC ID 5597844613, 2 clinicians

Practice addresses (Care Compare)

1945 S Main St
Morton, IL 61550-2968
Phone (309) 263-1017

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as individual
Quality
66.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue22
Removal of skin lesions78
Removal of nail tissue289
Removal or shaving of skin growth287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Podiatry Group, PC Podiatrist CurrentSince Jan 1, 2003 Accepting new patients

Locations

1945 S Main St
Morton, IL 61550
Phone (309) 263-1017

3827 N Prospect Rd
Peoria Hts, IL 61616
Phone (309) 686-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19358/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1013928365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 N PROSPECT RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61616",
            "telephone_number": "309-686-1000",
            "fax_number": "309-686-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 S MAIN ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "61550",
            "telephone_number": "309-263-1017",
            "fax_number": "309-266-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANCIUS",
        "first_name": "CHRISTINE",
        "middle_name": "CELESTE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA- RAILROAD ME",
            "identifier": "DA0891",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.