Andrew Poulos, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036161439 Issued in IL

Practice address

900 W Temple Ave Ste 1500
Effingham, IL 62401-2121

Phone

(217) 347-0458

Fax

(217) 342-2992

NPI assigned

Apr 15, 2014

Last updated

Sep 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS Home Care Illinois Home health agency, Effingham, IL, CCN 147661
• St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
• St Johns Hospital Hospital, Springfield, IL, CCN 140053

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apoulos181682@direct.thedacare.org

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.

• HSHS Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1962644807
  Medicare reassignment Care Compare group NPD
• HSHS Medical Group Inc

  dba HSHS Medical Group Family Medicine - Dieterich

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD
• SJL Health Systems Inc

  dba Prairie Rose Health Care Center

  • Skilled Nursing Facility
  • Pana, IL
  • NPI 1215037353
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• HSHS Medical Group Inc

  dba HSHS Medical Group Family & Internal Medicine - Effingham

  • Rural Health Clinic/Center
  • Effingham, IL
  • NPI 1265904486
  NPD (past)
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba St. Anthony's Memorial Hospital

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba St. Anthony's Memorial Hospitral

  • Clinic/Center
  • Effingham, IL
  • NPI 1881214104

  Hospital

  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba HSHS Home Care Illinois

  • Home Health Agency
  • Effingham, IL
  • NPI 1891758678
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. John's Hospital

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1760801120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE STE 1500",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012121",
            "telephone_number": "217-347-0458",
            "fax_number": "217-342-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE STE 1500",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012121",
            "telephone_number": "217-347-0458",
            "fax_number": "217-342-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 W Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016223",
            "country_code": "US",
            "telephone_number": "715-839-5175",
            "fax_number": "715-839-5176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULOS",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301113522",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036161439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apoulos110423@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "900 W Temple Ave Ste 1500",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donna Jean Pierson, RN
• Megan Amber Pittman, M.S., CCC/SLP-L
• Lisa E Plummer, ATC
• Julie Ann Poland, DT
• Dakota Pottle
• John B Powell, M.D.
• Jessica Jean Prange, M.D.
• Precision XP LLC (Precision Chiropractic)
• Christina Probst, RN
• Kristen M Probst

• Family Medicine Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.