NPIMap

Individual provider Active NPI

Kevin James McCarthy, M.D.

  • Orthopaedic Surgery Physician
  • O Fallon, IL
National Provider Identifier
1356579684
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036138387 Issued in IL
Practice address
670 Pierce Blvd
O Fallon, IL 62269-2579
Phone
(618) 206-2094
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 94-07207 KS
Orthopaedic Surgery Physician 207X00000X 036138387 IL Primary

Addresses

Primary practice location

670 Pierce Blvd
O Fallon, IL 62269-2579

Mailing address

670 Pierce Blvd
O Fallon, IL 62269-2579
Phone (618) 206-2094

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmccarthy101217@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702002308 IL Practitioner - Orthopedic Surgery 1951528710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1512 N Green Mount Rd
Suite 108
Ofallon, IL 62269-1953
Phone (618) 624-5510

1900 E Lake Shore Dr
Suite 330
Decatur, IL 62521-3848
Phone (217) 423-2889

670 Pierce Blvd
O Fallon, IL 62269-2579
Phone (618) 726-2133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement41
Knee replacement34
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
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

State licenses

LicenseStateTypeSpecialty
036138387ILMDOrthopaedic Surgery Physician
94-07207KSMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Aug 1, 2015 Accepting new patients
HSHS Medical Group Inc CurrentSince Aug 1, 2015 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients
CC Bpci PLC Orthopaedic Surgery Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

670 Pierce Blvd
O Fallon, IL 62269
Phone (618) 206-2070

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Interoperability endpoints

  • Direct secure messaging: kmccarthy101217@ewd.direct.hshs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1356579684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PIERCE BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692579",
            "telephone_number": "618-206-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PIERCE BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692579",
            "telephone_number": "618-206-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KS",
            "license": "94-07207",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036138387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccarthy101217@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "670 Pierce Blvd",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622692579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.