Individual provider Active NPI

Neil McClymont, D.O.

  • Emergency Medicine Physician
  • Belleville, IL
National Provider Identifier
1033248208
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.117348 Issued in IL
Practice address
4500 Memorial Dr
Memorial Hospital - ER
Belleville, IL 62226-5360
Phone
(618) 233-7750
Fax
(618) 257-6860
NPI assigned
Mar 5, 2007
Last updated
Jul 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2201 NE
Emergency Medicine Physician 207P00000X DO-05564 IA
Emergency Medicine Physician 207P00000X 20A18682 CA
Emergency Medicine Physician 207P00000X 036.117348 IL Primary

Addresses

Primary practice location

4500 Memorial Dr
Memorial Hospital - ER
Belleville, IL 62226-5360

Mailing address

2100 Powell St
Suite 920
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other identifiers 2

IdentifierTypeStateIssuer
036117348-8MedicaidIL
1033248208MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210803001520 CA Practitioner - Emergency Medicine 0547364382 Reassigns benefits to 1 organization
I20210830003501 FL Practitioner - Emergency Medicine 0547364382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A18682CAMDEmergency Medicine Physician
036.117348ILMDEmergency Medicine Physician
2201NEMDPhysical Therapy Assistant
18682CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Solano Gateway Medical Group Inc Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
HSHS Holy Family Hospital Inc Past Accepting new patients
Midwest Emergency Northern Illinois Inc Emergency Medicine Past Accepting new patients
Midway Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Foundation for Emergency Services Emergency Medicine Past Accepting new patients
Webster Emergency Physicians Emergency Medicine Past Accepting new patients
Foundation for Emergency Services Past Accepting new patients

Locations

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1033248208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "address_2": "MEMORIAL HOSPITAL - ER",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-233-7750",
            "fax_number": "618-257-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLYMONT",
        "first_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "2201",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "DO-05564",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A18682",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.117348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117348-8",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033248208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.