NPIMap

Individual provider Active NPI

Gary D Hayden, PA-C

  • Physician Assistant
  • Shelbyville, IL
National Provider Identifier
1992797625
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001274 Issued in IL
Practice address
1215 W Main St
Shelbyville, IL 62565-1252
Phone
(217) 774-4305
Fax
(217) 774-4306
NPI assigned
Aug 18, 2005
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085001274 IL
Physician Assistant 363A00000X 085-001274 IL Primary

Addresses

Primary practice location

1215 W Main St
Shelbyville, IL 62565-1252

Mailing address

1005 Health Center Dr Ste 201
Mattoon, IL 61938-4693
Phone (217) 238-6055

Other practice location 1

1000 Health Center Dr
Mattoon, IL 61938-9261
Phone (217) 258-2551

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
I20061208000297 IL Practitioner - Physician Assistant 8527067123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

101 Professional PLZ
Mattoon, IL 61938-9252
Phone (217) 238-3730

1215 W Main St
Shelbyville, IL 62565-1252
Phone (217) 774-4305

211 S Walnut St
Arthur, IL 61911-1269
Phone (217) 543-3444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-001274ILMDPhysician Assistant
085001274ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center Physician Assistant CurrentSince Apr 6, 2015 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Apr 6, 2015 Accepting new patients

Locations

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1215 W Main St
Shelbyville, IL 62565
Phone (217) 774-4305

Organizations & group practices 3

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 4

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1992797625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384693",
            "telephone_number": "217-238-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W MAIN ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625651252",
            "telephone_number": "217-774-4305",
            "fax_number": "217-774-4306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619389261",
            "country_code": "US",
            "telephone_number": "217-258-2551",
            "fax_number": "217-258-2256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "GARY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001274",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IL

Sources for this page

Verify at the official NPI Registry.