NPIMap

Individual provider Active NPI

Victoria Kalivoda -Popela, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Monmouth, IL
National Provider Identifier
1063408631
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
036075881 Issued in IL
Practice address
1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone
(309) 734-1414
Fax
(309) 734-0323
NPI assigned
Sep 20, 2005
Last updated
Feb 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036075881 IL Primary

Addresses

Primary practice location

1000 W Harlem Ave
Monmouth, IL 61462-1007

Mailing address

1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-1414

Other identifiers 1

IdentifierTypeStateIssuer
371352599001MedicaidIL

Other names 1

  • Dr. Victoria Popela Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000981 IL Practitioner - Family PracticePractitioner - Geriatric Medicine 7315833837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Chicago College of Osteopathy, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital AssociationGroup PAC ID 0244134682, 39 clinicians

Practice addresses (Care Compare)

1454 N County Rd
Suite 2050
Carthage, IL 62321-0160
Phone (217) 357-8500

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Memorial Hospital Association Current Accepting new patients
Memorial Hospital Association CurrentSince Nov 15, 2012 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jun 19, 2020 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Memorial Hospital Association CurrentSince Nov 15, 2012 Accepting new patients
Memorial Hospital Association CurrentSince Jan 24, 2026 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jun 19, 2020 Accepting new patients
Memorial Hospital Association Past Accepting new patients

Locations

209 E 5th St
Bowen, IL 62316
Phone (217) 842-5211

1450 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-2173

1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131

630 Locust St
Carthage, IL 62321
Phone (217) 357-2173

1471 Keokuk St
Hamilton, IL 62341
Phone (217) 847-3383

501 E Main St
La Harpe, IL 61450
Phone (217) 659-3844

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

Interoperability endpoints

  • Direct secure messaging: vpopela584766@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial HospitalCarthage, IL, CCN 14Z305 Hospital Corporate Director Sep 30, 2022
Memorial HospitalCarthage, IL, CCN 141305 Hospital Corporate Director Sep 30, 2022
Memorial Medical Clinic BowenBowen, IL, CCN 143456 Rural health clinic Corporate Officer Sep 30, 2022
Memorial Medical Clinics, Women & Family Medical GroupCarthage, IL, CCN 143405 Rural health clinic Corporate Director Sep 30, 2022
Memorial Medical Nauvoo ClinicNauvoo, IL, CCN 148547 Rural health clinic Corporate Director Sep 30, 2022
Memorial Medical Clinic LaharpeLa Harpe, IL, CCN 148534 Rural health clinic Corporate Director Sep 30, 2022
Memorial Medical Clinic CarthageCarthage, IL, CCN 148571 Rural health clinic Corporate Director Oct 1, 2022
Memorial Medical Clinic ColchesterColchester, IL, CCN 148572 Rural health clinic Corporate Director Jan 1, 2026
Memorial Medical Clinic BroadwayHamilton, IL, CCN 148676 Rural health clinic Corporate Director Sep 30, 2022

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1063408631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621007",
            "telephone_number": "309-734-1414",
            "fax_number": "309-734-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621007",
            "telephone_number": "309-734-1414",
            "fax_number": "309-734-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIVODA -POPELA",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036075881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371352599001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "POPELA",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Monmouth, IL

Sources for this page

Verify at the official NPI Registry.