David J Nyquist, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036-076188 Issued in IL

Practice address

4500 Memorial Dr
Belleville, IL 62226

Phone

(618) 257-6220

Fax

(618) 257-6679

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Electronic endpoints 1

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

Specialty

Hospitalist

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• BJC Hospice Hospice, Glen Carbon, IL, CCN 141637
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dnyquist617126@direct.carenet.org

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.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group NPD
• Highland Physicians LTD

  • Physician Assistant
  • Highland, IL
  • NPI 1427065580

  Family Medicine

  NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• BJC Home Care Services

  • Community Based Hospice Care Agency
  • Glen Carbon, IL
  • NPI 1316252463
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation
• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1114966611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-6220",
            "fax_number": "618-257-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-6220",
            "fax_number": "618-257-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 Cross St",
            "address_purpose": "LOCATION",
            "city": "Shiloh",
            "state": "IL",
            "postal_code": "622692988",
            "country_code": "US",
            "telephone_number": "618-257-6220",
            "fax_number": "618-257-6679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYQUIST",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36076188",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-076188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "187771",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE UHC",
            "identifier": "0104775",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080174497",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076188",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMR A DIVISION OF GHP",
            "identifier": "133289",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "006015346",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4080250",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN GHP",
            "identifier": "133289",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David C Norman, MD
• Lauren G Norrenberns, CPNP-PC
• Lynne Nowak, MD
• Nurturing by Faith Home Care, LLC
• Nurturing Essentials Doula Care LLC
• Kelly O'Brien
• Dwight William O'Dell, M.D.
• Amber O'Donnell, PT
• Richard John O'Donnell III, OTR/L
• Pamela A O'Neal, NP

• Hospitalist Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.