Individual provider Active NPI

James Francis Queenan III, D.O.

  • Orthopaedic Surgery Physician
  • Canton, IL
National Provider Identifier
1376535435
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036142261 Issued in IL
Practice address
180 S Main St
Canton, IL 61520-2608
Phone
(309) 647-0201
Fax
(309) 649-6880
NPI assigned
Aug 16, 2005
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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 2007018575 MO
Orthopaedic Surgery Physician 207X00000X 036142261 IL Primary

Addresses

Primary practice location

180 S Main St
Canton, IL 61520-2608

Mailing address

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

Other identifiers 1

IdentifierTypeStateIssuer
27640000MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address james.queenan@gmgil.eclinicaldirectplus.com Health Information Exchange (HIE) Graham Hospital Association

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
I20170428001471 IL Practitioner - Orthopedic Surgery 9032152533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

1630 E Jackson St
Macomb, IL 61455-2530
Phone (309) 647-0201

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

2028 N Seminary St
Galesburg, IL 61401-4559
Phone (309) 647-0201

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
62.57
Promoting interoperability
100
Improvement activities
40
Cost
77.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Hospital Association CurrentSince May 1, 2017 Accepting new patients
Graham Hospital Association CurrentSince May 1, 2017 Accepting new patients
Bone&Joint Specialist P.C. Orthopaedic Surgery Past Accepting new patients
Bone & Joint Specialists Physician Group, LLC Orthopaedic Surgery Past Accepting new patients

Locations

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1376535435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-647-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEENAN",
        "first_name": "JAMES",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2007018575",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036142261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27640000",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.queenan@gmgil.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Graham Hospital Association",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "180 S Main St",
            "city": "Canton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615202608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

Verify at the official NPI Registry.