DR. KELLY M FARROLL MD
NPI 1063503704
Family Medicine in Granite City, IL

Q: What is Kelly Farroll's NPI number?

The NPI number for Kelly Farroll is 1063503704. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Q: What is Kelly Farroll's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Farroll was last updated on February 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 27, 2006PECOS EnrolledAccepts Medicare Assignment

2166 MADISON AVE, GRANITE CITY, IL 62040(618) 452-3301(618) 452-3312 Get Directions Write a Review

NPPES record last updated: February 8, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Kelly M Farroll Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY M FARROLL MD (NPI 1063503704) is an individual family medicine provider in Granite City, Illinois, licensed in Illinois (036093514) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Gateway Regional Medical Center, and is a graduate of Southern Illinois University School Of Medicine (1993).

NPPES Registry Identity

NPI1063503704

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KELLY M FARROLLCredential: MD

Location Address2166 MADISON AVEGranite City, IL 62040-4700

Mailing Address2166 Madison AveGranite City, IL 62040-4700 · (618) 452-3301 · Fax (618) 452-3312

Phone(618) 452-3301

Fax(618) 452-3312

Sole ProprietorNo

Medical School CMSSouthern Illinois University School Of MedicineGraduated 1993

Enumeration DateSeptember 27, 2006

Last NPPES UpdateFebruary 8, 2023

NPPES CertifiedFebruary 8, 2023

✔ NPI 1063503704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036093514

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 036-093514 (IL)

2166 MADISON AVE, Granite City, IL 62040

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelly M Farroll Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931091592

PECOS Enrollment IDI20040327000375

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kelly Farroll reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern Illinois Healthcare Foundation, Inc

Same address

Federally Qualified Health Center (FQHC)

2166 MADISON AVENUE
Granite City, IL 62040

Reassigned Medicare billing, Illinois enrollment
164 clinicians in this Medicare group

NPI 1326392747 (618) 452-3301

Lincoln Surgical Associates, Ltd.

15 mi

Surgery

1414 CROSS ST STE 330
Shiloh, IL 62269

Reassigned Medicare billing, Illinois enrollment
24 clinicians in this Medicare group

NPI 1861706814 (618) 277-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Gateway Regional Medical Center

Acute Care Hospitals · Granite City, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140125

Location2100 Madison AvenueGranite City, IL 62040 · Madison County

Emergency services

St Josephs Hospital

Acute Care Hospitals · Breese, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number140145

Location9515 Holy Cross LnBreese, IL 62230 · Clinton County

Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Belleville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140185

Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County

Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

Washington County Hospital

Critical Access Hospitals · Nashville, IL

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141308

Location705 S Grand AveNashville, IL 62263 · Washington County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62040 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KARTHIKEYAN VADAKANTHARAI PARAMESWARAN MD

Pediatrics