Matthew Taylor Hefty, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036147642 Issued in IL

Practice address

215 E 1St St Ste 316
Dixon, IL 61021-3190

Phone

(815) 285-5842

Fax

(815) 285-5845

NPI assigned

Jul 12, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

General Surgery

Education

University of North Dakota School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012

Merit-based Incentive Payment System (MIPS)

Final score

82.78 of 100Reported as group

Quality

60.49

Promoting interoperability

100

Improvement activities

40

Cost

77.11

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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 Medicine

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Katherine Shaw Bethea Hospital

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1427043546
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
  • NPI 1992829485
  NPD (past)
• Illinois Urologic Health Surgeons SC

  • Urology Physician
  • Utica, IL
  • NPI 1316904964
  NPD (past)

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

• Osf Healthcare System

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  Care Compare affiliation

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1154633618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 316",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213190",
            "telephone_number": "815-285-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 316",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213190",
            "telephone_number": "815-285-5842",
            "fax_number": "815-285-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFTY",
        "first_name": "MATTHEW",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-12",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036147642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400525521",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATIONAL LIMITED LICENSE",
            "identifier": "4301096886",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PROVIDER NUMBER",
            "identifier": "376897",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Christine Hauser
• Judd Alexander Haushahn
• Sikander Hayat, M.D.
• Joanna Heeren, MS
• Susan Heffelfinger, PH.D
• Melissa Heisner
• Jarren Heitter, RBT
• Helen Woodrum LCSW PLLC
• Linda Hellmich, PHD
• Michael K Hemmen, MSW

• Surgery Physician in Dixon, IL
• Providers in Dixon, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.