NPIMap

Individual provider Active NPI

Jeffrey Michael Schenck, DO

  • Family Medicine Physician
  • Fairview Heights, IL
National Provider Identifier
1447713409
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036157832 Issued in IL
Practice address
5 Ludwig Dr
Fairview Heights, IL 62208-1332
Phone
(618) 397-9000
Fax
(618) 397-9003
NPI assigned
Apr 8, 2019
Last updated
Dec 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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 036157832 IL Primary

Addresses

Primary practice location

5 Ludwig Dr
Fairview Heights, IL 62208-1332

Mailing address

5 Ludwig Dr
Fairview Heights, IL 62208-1332
Phone (618) 397-9000

Other practice location 1

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone (618) 233-7880 ext. 44405

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jschenck257317@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
I20220707003430 IL Practitioner - Family Practice 2769711712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vituity - Illinois Auc LLPGroup PAC ID 0547516932, 35 clinicians
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

1512 N Green Mount Rd
O Fallon, IL 62269-2083
Phone (618) 624-3750

5 Ludwig Dr
Fairview Heights, IL 62208-1332
Phone (618) 397-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

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
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Jan 9, 2023 Accepting new patients
SJL Health Systems Inc CurrentSince Jan 9, 2023 Accepting new patients
Vituity - Illinois Auc LLP CurrentSince Jul 1, 2022 Accepting new patients
Vituity - Illinois Auc LLP CurrentSince Jul 1, 2022 Accepting new patients
Cep America-Illinois Hospitalists CurrentSince Jul 1, 2022 Accepting new patients
Cep America-Illinois Hospitalists, LLP CurrentSince Jul 1, 2022 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients
HSHS Prairie, Inc Current Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

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

801 W Temple Ave
Effingham, IL 62401
Phone (217) 342-5800

5 Ludwig Dr
Fairview Heights, IL 62208
Phone (618) 397-9000

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

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

3051 Hollis Dr
Springfield, IL 62704
Phone (217) 523-5406

Interoperability endpoints

  • Direct secure messaging: jschenck257317@ewd.direct.hshs.org

Organizations & group practices 9

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1447713409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LUDWIG DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081332",
            "telephone_number": "618-397-9000",
            "fax_number": "618-397-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LUDWIG DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081332",
            "telephone_number": "618-397-9000",
            "fax_number": "618-397-9003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 4000",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691284",
            "country_code": "US",
            "telephone_number": "618-233-7880 x44405",
            "fax_number": "618-222-4792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHENCK",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036157832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jschenck257317@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "5 Ludwig Dr",
            "city": "Fairview Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622081332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

Verify at the official NPI Registry.