John A Mattingly, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036096843 Issued in IL

Practice address

12 Wolf Creek Dr
Swansea, IL 62226-2314

Phone

(618) 277-7912

Fax

(618) 277-7915

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

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 2

Specialty

Diagnostic RadiologyAlso: Interventional Pain Management

Education

Saint Louis University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ernst Radiology Clinic IncGroup PAC ID 2264829639, 16 clinicians

Ernst Radiology Clinic, IncGroup PAC ID 2961488366, 20 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• SSM Health St. Mary's Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
• SSM Health St Mary's Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmattingly154395@direct-ehr-ssmhc.com

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.

• Ernst Radiology Clinic, Inc

  • Diagnostic Radiology Physician
  • Mount Vernon, IL
  • NPI 1699425462

  MO

  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Ernst Radiology Clinic, Inc

  • Diagnostic Radiology Physician
  • Bridgeton, MO
  • NPI 1629000971

  IL

  Medicare reassignment Care Compare group NPD
• USA Radiology Management Solutions LLC

  • Diagnostic Radiology Physician
  • Rolla, MO
  • NPI 1689091076
  Medicare reassignment NPD
• USA Radiology of Pennsylvania, LLC

  • Body Imaging Physician
  • Meadville, PA
  • NPI 1164907655

  MO

  Medicare reassignment
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Dr. David a Sciortino, LTD

  dba Sciortino Chiropractic

  • Chiropractor
  • Saint Louis, MO
  • NPI 1669509238
  NPD
• Specialt MRI, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Fenton, MO
  • NPI 1811740301

  Diagnostic Radiology

  NPD
• Elite Imaging of Fairview Heights, LLC

  • Radiology Clinic/Center
  • Swansea, IL
  • NPI 1407825342
  NPD (past)
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)
• Radiology Consultants of Mid-America, PC

  • Diagnostic Radiology Physician
  • Belleville, IL
  • NPI 1598716771
  NPD (past)
• Premier Radiology Associates, Inc.

  • Diagnostic Radiology Physician
  • Cheverly, MD
  • NPI 1871565994
  NPD (past)

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

• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• St Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health DePaul Hospital - St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Clare Hospital - Fenton

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation
• SSM Regional Health Services

  dba SSM Health St. Mary's Hospital Jefferson City

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1952355786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E FAIRWAY DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622232202",
            "telephone_number": "618-304-8392",
            "fax_number": "443-451-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WOLF CREEK DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262314",
            "telephone_number": "618-277-7912",
            "fax_number": "618-277-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036096843",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MO",
            "license": "103379",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "KY",
            "license": "42628",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IN",
            "license": "01066438A",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MD",
            "license": "D0068341",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "42628",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "103379",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01066438A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0068341",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036096843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01026934",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360916843",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366096843",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "376069",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Stewart Martin, D.C.
• Stephanie Martin
• Dirk F Massie, OD
• Master Medical Care LLC
• Cody V Mathews
• Rockael Mays
• Sherangelia Raichel McClain
• Richard Mark McCormick, MA
• Morgan Ashley McDaniel, LPC
• Deborah K McDermott, M.D.

• Diagnostic Radiology Physician in Swansea, IL
• Providers in Swansea, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.