Individual provider Active NPI

Thomas Dust, PA-C

  • Physician Assistant
  • Mattoon, IL
National Provider Identifier
1477984656
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-005945 Issued in IL
Practice address
1001 Health Center Dr
Mattoon, IL 61938-4693
Phone
(217) 258-2250
Fax
(217) 258-2249
NPI assigned
Dec 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-005945 IL Primary

Addresses

Primary practice location

1001 Health Center Dr
Mattoon, IL 61938-4693

Mailing address

PO Box 372
Mattoon, IL 61938-0372

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202000370 IL Practitioner - Physician Assistant 6507149358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1007 Health Ctr Dr
Mattoon, IL 61938-4693
Phone (217) 258-7400

101 Professional PLZ
Mattoon, IL 61938-9252
Phone (217) 238-3730

Hospital & facility affiliations

  • Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189
  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-005945ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center Physician Assistant CurrentSince Oct 18, 2016 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Oct 18, 2016 Accepting new patients

Locations

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1000 Health Center Dr
Ste 305
Mattoon, IL 61938
Phone (217) 258-4186

1001 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2250

1004 Health Center Dr
Ste 210
Mattoon, IL 61938
Phone (217) 238-4961

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

Organizations & group practices 3

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 3

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": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1477984656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384693",
            "telephone_number": "217-258-2250",
            "fax_number": "217-258-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUST",
        "first_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.