Active NPI
Michael Smith, M.D.
- Otolaryngology Physician
- Mattoon, IL
National Provider Identifier
1215043971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036-092274
- Practice address
- 1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653 - Phone
- (217) 258-2409
- Fax
- (217) 258-2323
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036-092274 | IL | Primary |
Addresses
Primary practice location
1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653
Mailing address
PO Box 372
Mattoon, IL 61938-0372
Other practice location 1
905 N Maple St
Effingham, IL 62401-6401
Phone (217) 347-7077
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Wake Forest University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Health Ctr Dr
Suite 201
Mattoon, IL 61938-4639
Phone (217) 258-4030
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.96 of 100
- Quality
- 69.5
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-092274 | IL | MD | Otolaryngology Physician |
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.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1215043971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 372",
"city": "MATTOON",
"state": "IL",
"postal_code": "619380372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 HEALTH CENTER DR STE 201",
"city": "MATTOON",
"state": "IL",
"postal_code": "619384653",
"telephone_number": "217-258-2409",
"fax_number": "217-258-2323"
}
],
"practiceLocations": [
{
"address_1": "905 N Maple St",
"address_purpose": "LOCATION",
"city": "Effingham",
"state": "IL",
"postal_code": "624016401",
"country_code": "US",
"telephone_number": "217-347-7077",
"fax_number": "217-347-7197",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036-092274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.