Individual provider Active NPI

Mark K Myers, M.D.

  • Family Medicine Physician
  • Oregon, IL
National Provider Identifier
1619945193
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-092866 Issued in IL
Practice address
1307 W Washington St
Oregon, IL 61061
Phone
(815) 732-3151
Fax
(815) 732-3718
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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 036-092866 IL Primary

Addresses

Primary practice location

1307 W Washington St
Oregon, IL 61061

Mailing address

1307 W Washington St
Oregon, IL 61061-1022
Phone (815) 732-3151

Other identifiers 1

IdentifierTypeStateIssuer
036092866MedicaidIL

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
I20101229000186 IL Practitioner - Family Practice 5395933725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

102 S Hennepin Ave
Suite 201
Dixon, IL 61021-3013
Phone (815) 288-7711

1307 W Washington St
Oregon, IL 61061-1001
Phone (815) 732-3151

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.78 of 100Reported as group
Quality
60.49
Promoting interoperability
100
Improvement activities
40
Cost
77.11

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 Medicine

State licenses

LicenseStateTypeSpecialty
036-092866ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Dec 17, 2024 Accepting new patients
KSB Medical Group, Inc. Family Medicine CurrentSince Aug 1, 1996 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
KSB Medical Group, Inc. CurrentSince Aug 1, 1996 Accepting new patients

Locations

215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477

215 E 1st St
Ste 117
Dixon, IL 61021
Phone (815) 285-5900

1307 W Washington St
Ste 145
Oregon, IL 61061

1307 W Washington St
Oregon, IL 61061
Phone (815) 732-3151

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 4

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 2

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1619945193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 W WASHINGTON ST",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610611022",
            "telephone_number": "815-732-3151",
            "fax_number": "815-732-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 W WASHINGTON ST",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "61061",
            "telephone_number": "815-732-3151",
            "fax_number": "815-732-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MARK",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-092866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092866",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, IL

Sources for this page

Verify at the official NPI Registry.