Donald Scott Crouch, M.D.
Individual provider Active NPI Surgery Physician · Shiloh, IL
NPI 1619925880 · NPPES record last updated Oct 24, 2019
Key facts
- NPI
- 1619925880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 036106785 (IL)
- Practice address
- 1414 Cross St Ste 330
Shiloh, IL 62269 - Phone
- (618) 277-7400
- Fax
- (618) 277-7422
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 5
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Saint Louis University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- HSHS Medical Group Inc
Lincoln Surgical Associates, LTD.
Practice addresses (Care Compare)
12860 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2810
12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600
1414 Cross St
Shiloh, IL 62269-2941
Phone (618) 277-7400
1512 N Green Mount Rd
Suite 108
Ofallon, IL 62269-1953
Phone (618) 624-5510
9409 Holy Cross Lane
Suite 113
Breese, IL 62230-3510
Phone (618) 526-8430
9515 Holy Cross Lane
Breese, IL 62230-3618
Phone (618) 526-4511
Hospital & facility affiliations
- Memorial Hospital
- HSHS St Elizabeth'S Hospital
- St Josephs Hospital
- St Joseph'S Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 53 |
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 16 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| HSHS St. Elizabeth'S Hospital |
Hospital | Corporate Director | Sep 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050221000072 | IL | Practitioner - General Surgery | 7214989045 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036106785 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Current | Accepting new patients | |
| HSHS Medical Group Inc | Current |
Accepting new patients | |
| HSHS Medical Group Inc | Current |
Accepting new patients | |
| Lincoln Surgical Associates, LTD. | Surgery | Current |
Accepting new patients |
| HSHS Medical Group Inc | Past | Accepting new patients | |
| Lincoln Surgical Group | Surgery | Past | Accepting new patients |
Locations
1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889
12860 Troxler Ave
Ste 300
Highland, IL 62249
Phone (618) 664-9831
1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100
1414 Cross St
Ste 330
Shiloh, IL 62269
Phone (618) 228-8610
Interoperability endpoints
- dcrouch153221@ewd.direct.hshs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036106785 | IL | Yes |
Addresses
Primary practice location
1414 Cross St Ste 330
Shiloh, IL 62269
Mailing address
1414 Cross St Ste 330
Shiloh, IL 62269-2988
Phone (618) 277-7400
Other practice location 1
3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 62269-1282
Phone (618) 234-3173
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036106785 | Medicaid | IL |
Other providers in Shiloh, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.