MICHELLE P MULLIGAN M.D.
NPI 1194721936
Family Medicine in Edwardsville, IL

Q: What is Michelle Mulligan's NPI number?

The NPI number for Michelle Mulligan is 1194721936. It was assigned to this individual provider in the NPPES registry on June 27, 2005.

Q: What is Michelle Mulligan'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 Michelle Mulligan was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 June 27, 2005PECOS EnrolledAccepts Medicare Assignment

74.42/100

CMS Quality Rating

3417 ANDERSON HEALTHCARE DR STE 200, EDWARDSVILLE, IL 62025(618) 288-8500(618) 288-8501 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Michelle P Mulligan M.d. NPPES

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

MICHELLE P MULLIGAN M.D. (NPI 1194721936) is an individual family medicine provider in Edwardsville, Illinois, licensed in Illinois (036081019) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of University Of Missouri, Kansas City, School Of Medicine (1986).

NPPES Registry Identity

NPI1194721936

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMICHELLE P MULLIGANCredential: M.D.

Location Address3417 ANDERSON HEALTHCARE DR STE 200Edwardsville, IL 62025-7784

Mailing Address6810 State Route 162, Box 215Maryville, IL 62062 · (618) 391-6495

Phone(618) 288-8500

Fax(618) 288-8501

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 1986

Enumeration DateJune 27, 2005

Last NPPES UpdateAugust 28, 2024

NPPES CertifiedAugust 28, 2024

✔ NPI 1194721936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036081019

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.

3417 ANDERSON HEALTHCARE DR STE 200, Edwardsville, IL 62025

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Other Identifiers 6

Other0107339United Healthcare

Other080021120IL · Rr Medicare

OtherN8565Group Health Plan

Other4622029IL · Administar

Medicaid036081019IL

Other180420Healthlink

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Michelle P Mulligan M.d. 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 ID2961546775

PECOS Enrollment IDI20100217000583

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 3

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.

107 services89 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.

43 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

38 services32 patients

Hospital Affiliations CMS Care Compare 4

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

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

Anderson Hospital

Acute Care Hospitals · Maryville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140289

Location6800 State Route 162Maryville, IL 62062 · Madison County

Emergency services Birthing friendly

Community Hospital Of Staunton

Critical Access Hospitals · Staunton, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141306

Location400 N Caldwell StStaunton, IL 62088 · Macoupin County

Emergency services

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number260032

LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62025 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.

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.

74.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.31

Promoting Interoperability

Improvement Activities

Cost

56.92

Reported Quality Measures

Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Percentage of children 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) and were not dispensed an antibiotic prescription on or three days after the episode

95%20 patients

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

99%143 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

72%197 patients4/55-star benchmark: 95%

Depression Utilization of the PHQ-9 Tool

The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit

Patients 4MonthsOfEnd: 6% · 47 patients

Patients 4MonthsOfStart: 6% · 36 patients

12%42 patients

Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation

Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months

47%47 patients2/55-star benchmark: 100%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

61%38 patients3/55-star benchmark: 100%

Diabetes: Foot Exam

The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year

44%54 patients2/55-star benchmark: 98%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

95%38 patients4/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

92%1,412 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

94%2,964 patients4/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

6%239 patients1/55-star benchmark: 98%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

92%86 patients4/55-star benchmark: 100%

One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk

Percentage of patients aged 18 years and older with one or more of the following: a history of injection drug use, receipt of a blood transfusion prior to 1992, receiving maintenance hemodialysis, OR birthdate in the years 1945-1965 who received one-time…

15%168 patients1/55-star benchmark: 85%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

55%947 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

42%820 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

44%552 patients3/55-star benchmark: 88%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

18%691 patients1/55-star benchmark: 96%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 99% · 658 patients

Patients tobacco: 25% · 68 patients

91%658 patients4/55-star benchmark: 98%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

62%552 patients3/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

81%947 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%947 patients1/55-star benchmark: 79%

Tobacco Use and Help with Quitting Among Adolescents

The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user

88%66 patients

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

Patients nutrition: 1% · 74 patients

Patients physicalActivity: 1% · 74 patients

97%74 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

1 supplier11 claims11 services$30.10 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier11 claims11 services$168.52 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 7

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

ROBIN RISKY DNP, APRN, FNP-C

Nurse Practitioner (Family)