Individual provider Active NPI

Michael Little, M.D.

  • Radiation Oncology Physician
  • Carterville, IL
National Provider Identifier
1093915902
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
036.129749 Issued in IL
Practice address
1300 Pin Oak Dr
Carterville, IL 62918-1665
Phone
(618) 985-3333
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 036.129749 IL Primary

Addresses

Primary practice location

1300 Pin Oak Dr
Carterville, IL 62918-1665

Mailing address

1400 Pin Oak Dr
Carterville, IL 62918-1600

Other identifiers 1

IdentifierTypeStateIssuer
036129749MedicaidIL

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
I20120718000121 IL Practitioner - Radiation Oncology 1052577160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Texas Medical School at Houston, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Radiation Oncology LLCGroup PAC ID 7315040474, 3 clinicians

Practice addresses (Care Compare)

1400 Pin Oak Dr
Carterville, IL 62918-1600
Phone 61898533332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
71.13
Promoting interoperability
100
Improvement activities
40
Cost
77.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.129749ILMDRadiation Oncology Physician

Interoperability endpoints

  • Direct secure messaging: mlittle15651@sih.direct-ci.com

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.

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": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1093915902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PIN OAK DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 PIN OAK DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181665",
            "telephone_number": "618-985-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036.129749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129749",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carterville, IL

Sources for this page

Verify at the official NPI Registry.