Individual provider Active NPI

John Patrick Scally, MD

  • Cardiovascular Disease Physician
  • O'Fallon, IL
National Provider Identifier
1508952318
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036128843 Issued in IL
Practice address
Three Saint Elizabeth Blvd Ste 2800
O Fallon, IL 62269-1282
Phone
(618) 233-6044
Fax
(833) 973-4218
NPI assigned
Oct 5, 2006
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036090218 IL
Cardiovascular Disease Physician 207RC0000X 036128843 IL Primary
Cardiovascular Disease Physician 207RC0000X 01056859A IN

Addresses

Primary practice location

Three Saint Elizabeth Blvd Ste 2800
O Fallon, IL 62269-1282

Mailing address

Three Saint Elizabeth Blvd Ste 2800
O Fallon, IL 62269-1282
Phone (618) 233-6044

Other identifiers 2

IdentifierTypeStateIssuer
P01576857OtherILRAILROAD
036128843MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jscally100142@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: 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
I20110927000548 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8527238161 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
George Washington University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Holy Family Hospital IncGroup PAC ID 7517879349, 25 clinicians

Practice addresses (Care Compare)

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

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600

1515 Main St
Highland, IL 62249-1656
Phone (618) 651-2831

200 Health Care Dr
Greenville, IL 62246-1154
Phone (618) 664-1230

211 S Burns Ave
Suite B
Sparta, IL 62286-1895
Phone (618) 443-2858

3 Saint Elizabeth Blvd
Suite 2800
O Fallon, IL 62269-1099
Phone (618) 233-6044

619 E Mason St
Springfield, IL 62701-1034
Phone (217) 788-0706

9515 Holy Cross LN
Breese, IL 62230-3618
Phone (618) 526-5452

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036090218ILMDSpecialist
01056859AINMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeths Hospital of the Hospital Sisters of the Third Order Current Accepting new patients
HSHS Holy Family Hospital Inc CurrentSince Aug 21, 2019 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Sep 1, 2011 Accepting new patients
St Josephs Hospital of the Hospital Sisters of the Third Order of St F CurrentSince May 21, 2022 Accepting new patients
St Josephs Hospital Breese of the Hospital Sisters of the Third Orde CurrentSince Jan 1, 2015 Accepting new patients
St Elizabeths Hospital of the Hospital Sisters of the Third Order CurrentSince Jan 1, 2015 Accepting new patients
St Josephs Hospital Breese of the Hospital Sisters of the Third Orde CurrentSince Jan 1, 2015 Accepting new patients
Prairie Cardiovascular Consultants LTD Cardiovascular Disease CurrentSince Sep 1, 2011 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

9515 Holy Cross Ln
Ste 1
Breese, IL 62230
Phone (618) 526-4511

409 W Oak St
Carbondale, IL 62901
Phone (618) 429-4455

1770 E Lake Shore Dr
Ste 105
Decatur, IL 62521
Phone (217) 329-1000

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

200 Health Care Dr
#1501
Greenville, IL 62246
Phone (616) 664-1230

12866 Troxler Ave
Highland, IL 62249
Phone (618) 651-2600

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

3 Saint Elizabeth Blvd
Ste 2800
O Fallon, IL 62269
Phone (618) 233-6044

9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511

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

619 E Mason St
#4P57
Springfield, IL 62701

619 E Mason St
Ste 4
Springfield, IL 62701

Interoperability endpoints

  • Direct secure messaging: jscally100142@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 6

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1508952318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THREE SAINT ELIZABETH BLVD STE 2800",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691282",
            "telephone_number": "618-233-6044",
            "fax_number": "833-973-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THREE SAINT ELIZABETH BLVD STE 2800",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691282",
            "telephone_number": "618-233-6044",
            "fax_number": "833-973-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALLY",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036090218",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036128843",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01056859A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01576857",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036128843",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jscally100142@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "Three Saint Elizabeth Blvd Ste 2800",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.