GRETCHEN L MAHANEY CALDWELL APN
NPI 1265763163
Nurse Practitioner in Springfield, IL
About Gretchen L Mahaney Caldwell Apn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRETCHEN L MAHANEY CALDWELL APN (NPI 1265763163) is an individual nurse practitioner in Springfield, Illinois, licensed in Illinois (209007736) and active in the NPI registry since January 2010. She is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and is a graduate of Southern Illinois University School Of Medicine (2009).
NPPES Registry Identity
Specialties & Licenses 2
Accepted 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
Gretchen L Mahaney Caldwell Apn 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.
Medicare Billing Reassignments
2Medicare enrollment records show Gretchen Mahaney Caldwell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Springfield, IL 62704
- Reassigned Medicare billing, Illinois enrollment
- 101 clinicians in this Medicare group
Effingham, IL 62401
- Reassigned Medicare billing, Illinois enrollment
- 104 clinicians in this Medicare group
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 5
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Anthonys Memorial Hospital
Acute Care Hospitals · Effingham, ILSt Johns Hospital
Acute Care Hospitals · Springfield, ILMc Donough District Hospital
Acute Care Hospitals · Macomb, ILMemorial Hospital
Critical Access Hospitals · Carthage, ILPana Community Hospital
Critical Access Hospitals · Pana, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Gretchen Mahaney Caldwell's NPI number?
The NPI number for Gretchen Mahaney Caldwell is 1265763163. It was assigned to this individual provider in the NPPES registry on January 18, 2010.
Where is Gretchen Mahaney Caldwell located?
Gretchen Mahaney Caldwell practices at 917 Clock Tower Dr Ste 130, Springfield, IL 62704. The listed phone number is (217) 553-9332.
What is Gretchen Mahaney Caldwell's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Gretchen Mahaney Caldwell enrolled in Medicare?
Yes. Gretchen Mahaney Caldwell 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.
Which organizations bill Medicare for Gretchen Mahaney Caldwell's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gretchen Mahaney Caldwell reassigns Medicare benefits to 2 organizations: Prairie Cardiovascular Consultants Ltd (Springfield, IL) and St Anthonys Memorial Hospital Of The Hospital Sisters Of The Third (Effingham, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gretchen Mahaney Caldwell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Gretchen Mahaney Caldwell accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Medica list Gretchen Mahaney Caldwell 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 Gretchen Mahaney Caldwell affiliated with any hospitals?
According to CMS data, Gretchen Mahaney Caldwell is affiliated with St Anthonys Memorial Hospital, St Johns Hospital, Mc Donough District Hospital, Memorial Hospital and Pana Community Hospital.
When was this NPI record last updated?
The NPPES record for Gretchen Mahaney Caldwell was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Gretchen L Mahaney Caldwell, APN · NPI 1265763163
Nurse Practitioner physician in Springfield, Illinois. Individual provider, active in the CMS NPPES registry since January 18, 2010.
## Identity
- **NPI:** 1265763163 (Entity type: Individual)
- **Enumerated:** January 18, 2010
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 209007736 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 917 CLOCK TOWER DR STE 130, Springfield, IL 62704-6043
- **Phone:** (217) 553-9332
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Prairie Cardiovascular Consultants Ltd (NPI 1982714218, Springfield, IL); St Anthonys Memorial Hospital Of The Hospital Sisters Of The Third (NPI 1306800602, Effingham, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Southern Illinois University School Of Medicine, class of 2009
## Record status
- **NPPES last updated:** January 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1265763163) · Data from the CMS NPPES public registry.