NPIMap

Individual provider Active NPI

Andrew John Hossler, M.D.

  • Family Medicine Physician
  • Carbondale, IL
National Provider Identifier
1710392428
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-143712 Issued in IL
Practice address
207 W Jackson St Ste 101
Carbondale, IL 62901-1408
Phone
(618) 457-6787
Fax
(618) 351-4804
NPI assigned
Jun 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036143712 IL
Family Medicine Physician 207Q00000X 036-143712 IL Primary

Addresses

Primary practice location

207 W Jackson St Ste 101
Carbondale, IL 62901-1408

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other identifiers 1

IdentifierTypeStateIssuer
214881OtherILMULTISPECIALTY GROUP PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahossler15804@sih.direct-ci.com

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
I20171212000827 IL Practitioner - Family Practice 6901021799 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

207 W Jackson St
Suite 101
Carbondale, IL 62901-1408
Phone (618) 457-6787

2421 W Main St
Suite a
Carbondale, IL 62901-1039
Phone (618) 529-3201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth12
Skin biopsy11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-143712ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince Oct 28, 2020 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 28, 2020 Accepting new patients
Siu Physicians & Surgeons, Inc Family Medicine CurrentSince Jan 8, 2018 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Oct 28, 2017 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jan 8, 2018 Accepting new patients
Board of Trustees of Southern Illinois University Family Medicine Current Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

207 W Jackson St
Carbondale, IL 62901
Phone (618) 351-9559

207 W Jackson St
Ste 101
Carbondale, IL 62901
Phone (618) 457-6787

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

Interoperability endpoints

  • Direct secure messaging: ahossler15804@sih.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Residential Hospice of Southern Illinois, LLCGlen Carbon, IL, CCN 141576 Hospice Contracted Managing Employee Dec 17, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 9

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1710392428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W JACKSON ST STE 101",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011408",
            "telephone_number": "618-457-6787",
            "fax_number": "618-351-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSLER",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036143712",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-143712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTISPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahossler15804@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "207 W Jackson St Ste 101",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.