Individual provider Active NPI

Steven R. Ginos, M.D.

  • Family Medicine Physician
  • Quincy, IL
National Provider Identifier
1740298942
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-072864 Issued in IL
Practice address
4800 Maine St
Quincy, IL 62305-5875
Phone
(217) 224-6423
Fax
(217) 214-5874
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 036-072864 IL Primary

Addresses

Primary practice location

4800 Maine St
Quincy, IL 62305-5875

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 224-6423

Other identifiers 1

IdentifierTypeStateIssuer
036072864MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

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
I20050822000078 IL Practitioner - Family Practice 1456344126 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-072864ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Jul 1, 2015 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jan 1, 2015 Accepting new patients
Sound Physicians of Illinois, LLC Family Medicine CurrentSince Jul 6, 2015 Accepting new patients
Siu Physicians & Surgeons, Inc Family Medicine CurrentSince Jan 1, 2015 Accepting new patients

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1005 Broadway St
Quincy, IL 62301

612 N 11th St
Ste A
Quincy, IL 62301
Phone (217) 228-2080

612 N 11th St
Ste B
Quincy, IL 62301
Phone (217) 224-9484

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

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

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

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1740298942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-224-6423",
            "fax_number": "217-214-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055875",
            "telephone_number": "217-224-6423",
            "fax_number": "217-214-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINOS",
        "first_name": "STEVEN",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-072864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072864",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.