NPIMap

Individual provider Active NPI

Kandace Lamonica, MD

  • Family Medicine Physician
  • O Fallon, IL
National Provider Identifier
1952864977
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125075203 Issued in IL
Practice address
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone
(618) 234-2120
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 318019 NY
Family Medicine Physician 207Q00000X 125075203 IL Primary

Addresses

Primary practice location

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099

Mailing address

4041 Chouteau Ave Apt 324
Saint Louis, MO 63110-1729

Other practice location 1

34 Spring St
New York, NY 10012-4107
Phone (212) 925-5000

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
I20230928001026 IL Practitioner - Family Practice 7517296668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America-Illinois Hospitalists, LLPGroup PAC ID 3274765904, 193 clinicians
Vituity - Illinois Auc LLPGroup PAC ID 0547516932, 35 clinicians

Practice addresses (Care Compare)

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

1512 N Green Mount Rd
O Fallon, IL 62269-2083
Phone (618) 624-3750

Hospital & facility affiliations

  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • St Josephs Hospital Hospital, Breese, IL, CCN 140145
  • St Joseph'S Hospital Hospital, Highland, IL, CCN 141336
  • SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
  • HSHS Holy Family Hospital Inc Hospital, Greenville, IL, CCN 140137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125075203ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Illinois Hospitalists CurrentSince Sep 1, 2023 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients
Cep America-Illinois Hospitalists, LLP CurrentSince Sep 1, 2023 Accepting new patients
New York City Health and Hospitals Corporation PastSince Mar 1, 2023 Accepting new patients
New York City Health and Hospitals Corporation PastSince Mar 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

Interoperability endpoints

  • Direct secure messaging: klamonica277327@nychhc.direct-ci.com

Organizations & group practices 6

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 6

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1952864977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 CHOUTEAU AVE APT 324",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Spring St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100124107",
            "country_code": "US",
            "telephone_number": "212-925-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAMONICA",
        "first_name": "KANDACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-02-16",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "318019",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125075203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.