Daniel A Liesen, MD

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

036115999 Issued in IL

Practice address

927 Broadway St
Quincy, IL 62301-2719

Phone

(217) 214-3447

Fax

(217) 214-5819

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

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

Specialty

General Surgery

Education

Southern Illinois University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blessing Hospital Hospital, Quincy, IL, CCN 140015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: danielliesen@bcs.allscriptsdirect.net
• FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
• Direct secure messaging: dliesen234661@direct.myadvocateaurora.org

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.

• Blessing Hospital

  • Multi-Specialty Clinic/Center
  • Quincy, IL
  • NPI 1114471737
  Medicare reassignment Care Compare group NPD
• Scheer Surgical SC

  • Trauma Surgery Physician
  • Gurnee, IL
  • NPI 1437333747
  Medicare reassignment NPD
• Blessing Hospital

  • Rural Health Clinic/Center
  • Monroe City, MO
  • NPI 1013683507
  NPD
• Blessing Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Quincy, IL
  • NPI 1558489021
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Blessing Hospital

  • Nurse Practitioner
  • Quincy, IL
  • NPI 1417204827

  Hospital

  Care Compare affiliation
• Blessing Hospital

  • General Acute Care Hospital
  • Quincy, IL
  • NPI 1760571699
  Care Compare affiliation

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1386747731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-214-3447",
            "fax_number": "217-214-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012719",
            "telephone_number": "217-214-3447",
            "fax_number": "217-214-5819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Tower Ct Ste A",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600315711",
            "country_code": "US",
            "telephone_number": "847-505-7965",
            "fax_number": "847-244-3560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIESEN",
        "first_name": "DANIEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-02-02",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036115999",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036115999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115999",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036115999",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dliesen234661@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20 Tower Ct Ste A",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.liesen.1@20288.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20 Tower Ct Ste A",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darr W Leutz, MD
• Anna Levin, M.D.
• Eric Ley, P.T.
• Mervi Hannele Leyendeckers, O.D.
• Kathleen Finley Licavoli, O.T.
• Sara Liesen, MS, CF-SLP
• Limitless Medical
• Lincare Inc.
• Linda K. Simons
• Amanda Marie Lindsey

• Trauma Surgery Physician in Quincy, IL
• Providers in Quincy, IL by specialty
• Trauma Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.

Verify at the official NPI Registry.