Individual provider Active NPI

William Alan Bishop

  • Surgery Physician
  • Mount Vernon, IL
National Provider Identifier
1235633389
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036172220 Issued in IL
Practice address
2 Good Samaritan Way Ste 235
Mount Vernon, IL 62864-2476
Phone
(618) 899-3980
NPI assigned
Mar 22, 2018
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036172220 IL Primary

Addresses

Primary practice location

2 Good Samaritan Way Ste 235
Mount Vernon, IL 62864-2476

Mailing address

213 Freedom LN
Waterville, OH 43566-1141
Phone (419) 277-0576

Other practice location 1

213 Freedom Ln
Waterville, OH 43566-1141
Phone (419) 277-0576

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
I20241112002264 IL Practitioner - General Surgery 2466780879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Virginia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians

Practice addresses (Care Compare)

2 Good Samaritan Way
Suite 235
Mount Vernon, IL 62864-2476
Phone (618) 899-3970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)11
Upper gastrointestinal (GI) endoscopy for acid reflux13
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036172220ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services Corporation of Southern Illinois Inc. Surgery CurrentSince Oct 15, 2024 Accepting new patients

Locations

2 Good Samaritan Way
Ste 235
Mount Vernon, IL 62864
Phone (618) 899-3970

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

Interoperability endpoints

  • Direct secure messaging: wbishop522287@direct-ehr-ssmhc.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, 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": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1235633389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 FREEDOM LN",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435661141",
            "telephone_number": "419-277-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY STE 235",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642476",
            "telephone_number": "618-899-3980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Freedom Ln",
            "address_purpose": "LOCATION",
            "city": "Waterville",
            "state": "OH",
            "postal_code": "435661141",
            "country_code": "US",
            "telephone_number": "419-277-0576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "WILLIAM",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036172220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.