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DR. JAMES RAYMOND KIRKPATRICK M.D., PH.D.
NPI 1225471915
Family Medicine in Chester, IL

Active since April 11, 2013PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1900 STATE ST, CHESTER, IL 62233(618) 826-2388(618) 826-5139 Get Directions Write a Review

NPPES record last updated: January 17, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 22, 2021, Mar 17, 2018, Feb 15, 2018 and 1 more (4 updates tracked since 2016).

About Dr. James Raymond Kirkpatrick M.d., Ph.d. NPPES

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

DR. JAMES RAYMOND KIRKPATRICK M.D., PH.D. (NPI 1225471915) is an individual family medicine provider in Chester, Illinois, licensed in Illinois (036.142510) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital Of Carbondale, and maintains a secondary practice location in Steeleville.

NPPES Registry Identity

NPI1225471915
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES RAYMOND KIRKPATRICKCredential: M.D., PH.D.
Location Address1900 STATE STChester, IL 62233-1116
Mailing Address1900 State StChester, IL 62233-1116 · (618) 826-2388 · Fax (618) 826-5139
Phone(618) 826-2388
Fax(618) 826-5139
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 2013
Enumeration DateApril 11, 2013
Last NPPES UpdateJanuary 17, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2025
✔ NPI 1225471915 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 · 036.142510
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.
1900 STATE ST, Chester, IL 62233
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Secondary Practice Location 1

Location 1602 W Shawneetown TrlSteeleville, IL 62288-1126 · Phone (618) 965-3382

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

Dr. James Raymond Kirkpatrick M.d., Ph.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 ID1052629847
PECOS Enrollment IDI20170706001029
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 4

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
33 services21 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
26 services25 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
15 services15 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140164
Location405 W JacksonCarbondale, IL 62901 · Jackson 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

Memorial Hospital

Critical Access Hospitals · Chester, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141338
Location1900 State StChester, IL 62233 · Randolph County
Emergency services

Red Bud Regional Hospital

Critical Access Hospitals · Red Bud, IL
OwnershipProprietary
CMS Certification Number141348
Location325 Spring StreetRed Bud, IL 62278 · Randolph County
Emergency services

Sparta Community Hospital

Critical Access Hospitals · Sparta, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141349
Location818 E BroadwaySparta, IL 62286 · Randolph County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62233 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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 18

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
5 suppliers44 claims109 services$6.67 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
3 suppliers22 claims34 services$1.18 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers19 claims19 services$105.77 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers18 claims54 services$41.41 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers12 claims12 services$72.16 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers18 claims18 services$25.09 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 20

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

CHERYL L SAUERHAGE
Physical Therapist
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-4588
JASON DEAN ROY PT
Physical Therapist
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-4588
STOKES INSTITUTE OF UROLOGY
Specialist
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-4581
BRETT PRYWITCH
Radiology (Diagnostic Radiology)
1900 STATE ST, CHESTER MEMORIAL HOSPITAL
CHESTER, IL 62233
Randolph County (618) 826-4581
CHESTER MEDICAL GROUP LLC
Specialist
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-4581
DEBRA KAY ROHLFING MOT, OTR/L, CLT
Occupational Therapist
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-4581
KATHLEEN ANN WINKLER RPH
Pharmacist
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-6134
DR. JOSEPH PATRICK MOLNAR D.O.
Family Medicine
1900 STATE ST
CHESTER, IL 62233
Randolph County (618) 826-2388

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 James Kirkpatrick's NPI number?

The NPI number for James Kirkpatrick is 1225471915. It was assigned to this individual provider in the NPPES registry on April 11, 2013.

Where is James Kirkpatrick located?

James Kirkpatrick practices at 1900 State St, Chester, IL 62233. The listed phone number is (618) 826-2388.

What is James Kirkpatrick's specialty?

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

Is James Kirkpatrick enrolled in Medicare?

Yes. James Kirkpatrick 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.

What insurance does James Kirkpatrick accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list James Kirkpatrick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Kirkpatrick affiliated with any hospitals?

According to CMS data, James Kirkpatrick is affiliated with Memorial Hospital Of Carbondale, Memorial Hospital, Red Bud Regional Hospital and Sparta Community Hospital.

When was this NPI record last updated?

The NPPES record for James Kirkpatrick was last updated on January 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.