NPIMap

Organization Active NPI

Quincy Physicians & Surgeons Clinic, PLLC

Doing business as Quincy Medical Group Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Quincy, IL
National Provider Identifier
1245862002
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC
Doing business as
Quincy Medical Group Surgery Center
Practice address
3301 Broadway St.
Quincy, IL 62301
Phone
(217) 222-6550
NPI assigned
Feb 10, 2020
Last updated
Dec 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
QUINCY PHYSICIANS & SURGEONS CLINIC, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Patty Woerman
Title
Credentialing Specialist
Phone
(217) 222-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3301 Broadway St.
Quincy, IL 62301

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Other names 1

  • Quincy Medical Group Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210514001585 IL Part B Supplier - Ambulatory Surgical Center 0749192375 Practice locations: Quincy, IL

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Quincy Physicians Surgeons Clinic Dba Quincy Medical Group Surgery CenterCCN 14C0001187
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Quincy Physicians PLLC25 organizations share this tax ID, including this one
Part of
Quincy Physicians PLLC

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1245862002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BROADWAY ST.",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "62301",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC",
        "enumeration_date": "2020-02-10",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "WOERMAN",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "217-222-6550"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quincy Medical Group Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quincy Medical Group Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.