MICHAEL SMITH M.D.
NPI 1215043971
Otolaryngology in Mattoon, IL

Q: What is Michael Smith's NPI number?

The NPI number for Michael Smith is 1215043971. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Q: What is Michael Smith's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Smith was last updated on November 8, 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 August 22, 2006PECOS EnrolledAccepts Medicare Assignment

91.8/100

CMS Quality Rating

1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938(217) 258-2409(217) 258-2323 Get Directions Write a Review

NPPES record last updated: November 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 8, 2024, Jan 7, 2019 (2 updates tracked since 2019).

On this page

About Michael Smith M.d. NPPES

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

MICHAEL SMITH M.D. (NPI 1215043971) is an individual otolaryngology provider in Mattoon, Illinois, licensed in Illinois (036-092274) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Sarah Bush Lincoln Health Center, and maintains a secondary practice location in Effingham.

NPPES Registry Identity

NPI1215043971

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameMICHAEL SMITHCredential: M.D.

Location Address1005 HEALTH CENTER DR STE 201Mattoon, IL 61938-4653

Mailing AddressPo Box 372Mattoon, IL 61938-0372

Phone(217) 258-2409

Fax(217) 258-2323

Sole ProprietorNo

Medical School CMSWake Forest University School Of MedicineGraduated 1991

Enumeration DateAugust 22, 2006

Last NPPES UpdateNovember 8, 20242 updates tracked since enumeration

NPPES CertifiedNovember 8, 2024

✔ NPI 1215043971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in IL · 036-092274

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

1005 HEALTH CENTER DR STE 201, Mattoon, IL 61938

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Secondary Practice Location 1

Location 1905 N Maple StEffingham, IL 62401-6401 · Phone (217) 347-7077 · Fax (217) 347-7197

Accepted Insurance

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

Michael Smith 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 ID2567506488

PECOS Enrollment IDI20100216000537

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 Reassignment

Medicare enrollment records show Michael Smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sarah Bush Lincoln Health Center

0.1 mi

Family Medicine

1000 HEALTH CENTER DR
Mattoon, IL 61938

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

NPI 1568581379 (217) 258-2525

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

Areas of Expertise CMS Part B claims 16

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.

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

112 services108 patients

Sleep study including heart rate, breathing, airflow, and effort 95806

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

81 services81 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

70 services69 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.

55 services51 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

49 services49 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

30 services30 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

25 services21 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

23 services23 patients

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

23 services22 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

21 services18 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

19 services17 patients

Diagnostic exam of voice box using a flexible endoscope 31575

16 services15 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.

16 services16 patients

Removal of impacted ear wax 69210

14 services12 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

13 services12 patients

Incision of eardrum with insertion of eardrum tube under local or topical anesthesia 69433

This procedure, known as a Myringotomy with Tube Insertion, involves making a small incision in the eardrum to drain fluid and relieve pressure. A tiny tube is then placed in the eardrum to prevent future fluid buildup. It's done under local or topical anesthesia.

13 services13 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.

91.8/100

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

Scored through an Alternative Payment Model

Quality

75.59

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

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

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

2 suppliers11 claims11 services$119.76 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 9

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

LORI CUDONE M.D.

Otolaryngology