NPIMap

Individual provider Active NPI

John Michael Cerny, M.D.

  • Family Medicine Physician
  • Anna, IL
National Provider Identifier
1407852825
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036066934 Issued in IL
Practice address
515 N Main St
Anna, IL 62906-1668
Phone
(618) 833-3300
NPI assigned
Jun 21, 2005
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036066934 IL Primary

Addresses

Primary practice location

515 N Main St
Anna, IL 62906-1668

Mailing address

515 N Main St
Anna, IL 62906-1668
Phone (618) 833-3300

Other identifiers 7

IdentifierTypeStateIssuer
036066934MedicaidIL
N8453OtherILGHP PROV. #
09100030OtherILBCBS PROVIDER NUMBER
109812OtherILHEALTHLINK PROVIDER #
029385OtherILHEALTH ALLIANCE PROV. #
080007449OtherILR.R. MEDICARE PROV. #
371217285OtherILTAX ID

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
I20040525001033 IL Practitioner - Family Practice 6709867930 Practice locations: Anna, IL; Vienna, IL; Jonesboro, IL; Cobden, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 N Main St
Anna, IL 62906-1668
Phone (618) 833-3300

517 N Main St
Anna, IL 62906-1668
Phone (618) 833-4511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.13 of 100Reported as individual
Quality
73.54
Improvement activities
40
Cost
82.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions50
Removal of nail tissue1-10
Removal or shaving of skin growth25
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Past Accepting new patients
Holly Hill Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: clinical@mjc.directbygreenway.com
  • Direct secure messaging: jcerny@yourcarecommunity.org

Organizations & group practices 2

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 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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1407852825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061668",
            "telephone_number": "618-833-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061668",
            "telephone_number": "618-833-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERNY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036066934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036066934",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP PROV. #",
            "identifier": "N8453",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "09100030",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER #",
            "identifier": "109812",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PROV. #",
            "identifier": "029385",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE PROV. #",
            "identifier": "080007449",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "371217285",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anna, IL

Sources for this page

Verify at the official NPI Registry.