MR. KEITH E. BALLINGER PA C
NPI 1114934759
Urology in Mattoon, IL

Active since August 02, 2006PECOS EnrolledAccepts Medicare Assignment
95.01/100
CMS Quality Rating
1000 HEALTH CENTER DR STE 305, MATTOON, IL 61938(217) 258-4186(217) 348-4185 Get Directions Write a Review

NPPES record last updated: October 22, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2024, Nov 11, 2022, Apr 21, 2022 and 3 more (6 updates tracked since 2017).

About Mr. Keith E. Ballinger Pa C NPPES

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

MR. KEITH E. BALLINGER PA C (NPI 1114934759) is an individual urology provider in Mattoon, Illinois, licensed in Illinois (085001872) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Sarah Bush Lincoln Health Center, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1114934759
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameMR. KEITH E. BALLINGERCredential: PA C
Location Address1000 HEALTH CENTER DR STE 305Mattoon, IL 61938-4644
Mailing AddressPo Box 372Mattoon, IL 61938-0372
Fax(217) 348-4185
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateAugust 2, 2006
Last NPPES UpdateOctober 22, 20246 updates tracked since enumeration
NPPES CertifiedOctober 22, 2024
NPI 1114934759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License Licensed in IL · 085001872
Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Also ListedPhysician AssistantTaxonomy 363A00000X · License 085001872 (IL)
1000 HEALTH CENTER DR STE 305, Mattoon, IL 61938

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Keith E. Ballinger Pa C 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 ID9931197910
PECOS Enrollment IDI20040506000542
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.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
426 services286 patients
Electronic assessment of bladder emptying 51741
Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.
181 services146 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
137 services102 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
92 services80 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
73 services67 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
65 services56 patients

Hospital Affiliations CMS Care Compare

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

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140189
Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61938 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.02
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers11 claims28 services$6.91 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers11 claims30 services$2.70 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers26 claims26 services$19.08 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers38 claims38 services$97.45 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
2 suppliers23 claims1,410 services$0.07 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers30 claims30 services$21.77 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

Urology
1000 HEALTH CENTER DR STE 305
MATTOON, IL 61938
Nurse Practitioner
1000 HEALTH CENTER DR STE 305
MATTOON, IL 61938
Urology
1000 HEALTH CENTER DR STE 305
MATTOON, IL 61938

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Ballinger's NPI number?

The NPI number for Keith Ballinger is 1114934759. It was assigned to this individual provider in the NPPES registry on August 2, 2006.

Where is Keith Ballinger located?

Keith Ballinger practices at 1000 Health Center Dr Ste 305, Mattoon, IL 61938. The listed phone number is (217) 258-4186.

What is Keith Ballinger's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Keith Ballinger enrolled in Medicare?

Yes. Keith Ballinger is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Keith Ballinger affiliated with any hospitals?

According to CMS data, Keith Ballinger is affiliated with Sarah Bush Lincoln Health Center.

When was this NPI record last updated?

The NPPES record for Keith Ballinger was last updated on October 22, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.