NPIMap

Individual provider Active NPI

Cristy A Elving-Dial, MD

  • Family Medicine Physician
  • Jerseyville, IL
National Provider Identifier
1922056506
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036105358 Issued in IL
Practice address
390 Maple Summit Rd
Jerseyville, IL 62052
Phone
(618) 448-2101
Fax
(618) 498-8153
NPI assigned
May 5, 2006
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 036105358 IL Primary

Addresses

Primary practice location

390 Maple Summit Rd
Jerseyville, IL 62052

Mailing address

390 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-7518

Other practice location 1

523 S Main St
Carrollton, IL 62016-1256
Phone (217) 942-3326

Other practice location 2

220 E County Rd
Jerseyville, IL 62052-3125
Phone (618) 498-8467

Other identifiers 2

IdentifierTypeStateIssuer
P00174372OtherILMEDICARE RAILROAD
036105358MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address celving@jch.cernerdirect.com Health Information Exchange (HIE)

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
I20040921000417 IL Practitioner - Family Practice 0446228142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Practice addresses (Care Compare)

270 Maple Summit Rd
Jerseyville, IL 62052-2004
Phone (618) 498-7108

390 Maple Summit Rd
Jerseyville, IL 62052-2000
Phone (618) 498-2101

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

523 S Main St
Carrollton, IL 62016-1256
Phone (217) 942-3326

Hospital & facility affiliations

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 nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey Community Hospital District Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Jersey Community Hospital Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Jersey Community Hospital Current Accepting new patients
Jersey Community Hospital District Past Accepting new patients

Locations

103 McCausland St
Carlinville, IL 62626
Phone (217) 854-2623

523 S Main St
Carrollton, IL 62016
Phone (217) 942-3326

220 E County Rd
Jerseyville, IL 62052
Phone (618) 498-2273

270 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-7108

390 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-2101

400 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-6402

Interoperability endpoints

  • Direct secure messaging: celving@jch.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1922056506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "62052",
            "telephone_number": "618-498-7518",
            "fax_number": "618-498-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "62052",
            "telephone_number": "618-448-2101",
            "fax_number": "618-498-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 S Main St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "IL",
            "postal_code": "620161256",
            "country_code": "US",
            "telephone_number": "217-942-3326",
            "fax_number": "217-942-9833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 E County Rd",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620523125",
            "country_code": "US",
            "telephone_number": "618-498-8467",
            "fax_number": "618-639-2017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELVING-DIAL",
        "first_name": "CRISTY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036105358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00174372",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105358",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celving@jch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "HIE JERSEY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "390 Maple Summit Rd",
            "city": "Jerseyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jerseyville, IL

Sources for this page

Verify at the official NPI Registry.