Individual provider Active NPI

Michael J Wells, M.D.

  • Family Medicine Physician
  • Galena, IL
National Provider Identifier
1023082807
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036110728 Issued in IL
Practice address
1 Medical Center Dr
Galena, IL 61036-8118
Phone
(815) 776-7381
Fax
(815) 776-7274
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036110728 IL Primary

Addresses

Primary practice location

1 Medical Center Dr
Galena, IL 61036-8118

Mailing address

1 Medical Center Dr
Galena, IL 61036-8118
Phone (815) 776-7381

Other identifiers 1

IdentifierTypeStateIssuer
036110728MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address midwestmedical@midwestmedicalcenter.cernerdirect.com Direct

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
I20040910000217 IL Practitioner - Family Practice 2961474317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Medical CenterGroup PAC ID 5698771848, 36 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Galena, IL 61036-8118
Phone (815) 777-1340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110728ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Medical Center CurrentSince Apr 16, 2007 Accepting new patients
Midwest Medical Center CurrentSince Apr 16, 2007 Accepting new patients

Locations

1 Medical Center Dr
Galena, IL 61036
Phone (815) 776-7381

Interoperability endpoints

  • Direct secure messaging: midwestmedical@midwestmedicalcenter.cernerdirect.com
  • Direct secure messaging: mwells@midwestmedicalcenter.cernerdirect.com

Organizations & group practices 2

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1023082807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368118",
            "telephone_number": "815-776-7381",
            "fax_number": "815-776-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368118",
            "telephone_number": "815-776-7381",
            "fax_number": "815-776-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036110728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110728",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "midwestmedical@midwestmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Midwest Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Medical Center Dr",
            "city": "Galena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610368118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Galena, IL

Sources for this page

Verify at the official NPI Registry.