DR. JAMES MICHAEL BOCK M.D.
NPI 1285643825
Family Medicine in Decatur, IL
Quality Rating: 94.61 out of 100 score
NPI Status: Active since August 05, 2006
Contact Information
4965 E LOST BRIDGE RD
DECATUR, IL
ZIP 62521
Phone: (217) 864-5531
- Individual
- Male
- Years of Experience 39
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JAMES BOCK
This page provides the complete NPI Profile along with additional information for James Bock, a primary care provider established in Decatur, Illinois with a medical specialization in Family Medicine and more than 39 years of experience. He graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 1987. The healthcare provider is registered in the NPI registry with number 1285643825 assigned on August 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 036-077533 (IL). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1285643825
- Provider Name
- DR. JAMES MICHAEL BOCK M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4965 E LOST BRIDGE RD DECATUR, IL 62521
- Location Phone
- (217) 864-5531
- Mailing Address
- 113 E SEIBERLING ST BLUE MOUND, IL 62513
- Mailing Phone
- (217) 692-2151
- Mailing Fax
- Medical School Name
- UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
- Graduation Year
- 1987
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-05-2006
- Last Update Date
- 03-07-2023
- Code Navigator
A primary care provider (PCP) like James Bock sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036-077533
- License State
- IL
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 036-077533 | MEDICAID (05) | IL | |
| 036-077533 | OTHER (01) | IL | STATE LICENSE |
Medicare Participation & PECOS Enrollment Status
James Bock is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
James Bock is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7618030560
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090120000527
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Adm sarscov2 100mcg/0.5ml3rd
Adm sarscov2 30mcg/0.3ml 3rd
Adm sarscov2 30mcg/0.3ml bst
Adm sarscov2 50mcg/0.25mlbst
Adm sarscv2 30mcg trs-sucr 3
Adm sarscv2 30mcg trs-sucr b
Administration of influenza virus vaccine
Automated urinalysis test
Bilirubin level, direct
Blood count, hemoglobin
Blood creatinine level
Blood glucose (sugar) level
Blood potassium level
Blood test, basic group of blood chemicals (calcium, total)
Blood test, clotting time
Blood test, comprehensive group of blood chemicals
Blood test, lipids (cholesterol and triglycerides)
Blood test, thyroid stimulating hormone (tsh)
Calcium level, total
Coagulation function measurement, d-dimer; quantitative
Complete blood cell count (red cells, white blood cell, platelets), automated test
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Creatine kinase (cardiac enzyme) level, total
Creatinine level to test for kidney function or muscle injury
Cyanocobalamin (vitamin b-12) level
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza
Detection test by immunoassay with direct visual observation for influenza virus
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)
Dxa bone density measurement of hip, pelvis, spine
Fee covid-19 vac 13 res
Ferritin (blood protein) level
Folic acid level, serum
Hemoglobin a1c level
Influenza vaccine split virus, preservative free
Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage
Insertion of needle into vein for collection of blood sample
Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose
Iron binding capacity
Iron level
Kidney function blood test panel
Lipase (fat enzyme) level
Liver enzyme (sgot), level
Liver enzyme (sgpt), level
Liver function blood test panel
Magnesium level
Manual urinalysis test with examination using microscope, automated
Measurement c-reactive protein for detection of infection or inflammation
Natriuretic peptide (heart and blood vessel protein) level
Phosphate level
Prostate cancer screening; prostate specific antigen test (psa)
Psa (prostate specific antigen) measurement, total
Red blood cell concentration measurement
Red blood cell sedimentation rate, to detect inflammation, automated
Screening test for pathogenic organisms
Stool analysis for blood, by fecal hemoglobin determination by immunoassay
Thyroxine (thyroid chemical), free
Thyroxine (thyroid chemical), total
Transferrin (iron binding protein) level
Uric acid level, blood
Urinalysis using microscope
Urine microalbumin (protein) level
Vitamin d-3 level
X-ray of abdomen, 1 view
X-ray of ankle, minimum of 3 views
X-ray of both hips, 3-4 views
X-ray of chest, 2 views
X-ray of elbow, minimum of 3 views
X-ray of finger, minimum of 2 views
X-ray of foot, 2 views
X-ray of foot, minimum of 3 views
X-ray of forearm, 2 views
X-ray of hand, minimum of 3 views
X-ray of hip, 2-3 views
X-ray of knee, 1-2 views
X-ray of knee, 3 views
X-ray of lower and sacral spine, 2-3 views
X-ray of lower leg, 2 views
X-ray of middle spine, 3 views
X-ray of paranasal sinus, minimum of 3 views
X-ray of ribs on side of body, 2 views
X-ray of ribs on side of body, minimum of 3 views
X-ray of sacrum and tailbone, minimum of 2 views
X-ray of shoulder, minimum of 2 views
X-ray of thigh bone, minimum 2 views
X-ray of upper arm, minimum of 2 views
X-ray of upper spine, 2-3 views
X-ray of wrist, minimum of 3 views
This is the administration of a third dose of a SARS-CoV-2 vaccine, given in a dose of 100 micrograms in 0.5 milliliters. This vaccine helps your body develop immunity against the COVID-19 virus. It's a crucial step in protecting your health.
This service was performed 58 times for 58 patientsThis refers to the administration of a 30 microgram dose of a SARS-CoV-2 vaccine in a 0.3 milliliter volume. It's the third dose, often referred to as a booster shot, which helps to strengthen your body's immune response against the COVID-19 virus.
This service was performed 19 times for 19 patientsThis is an administration of a COVID-19 vaccine, specifically 30 micrograms in a 0.3 milliliter dosage. The vaccine helps your body build protection against the SARS-CoV-2 virus, which causes COVID-19.
This service was performed 77 times for 77 patientsThis procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.
This service was performed 68 times for 68 patientsThis refers to the administration of a 30 microgram dosage of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr 3' part indicates it's stabilized with a sugar solution. This vaccine helps your immune system fight off the virus if you're exposed.
This service was performed 59 times for 59 patientsThis service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.
This service was performed 330 times for 328 patientsThe administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 145 times for 145 patientsAn 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.
This service was performed 73 times for 69 patientsA direct bilirubin test measures a form of bilirubin in your blood. Bilirubin is a substance produced during the normal breakdown of red blood cells. High levels may indicate liver or blood disorders. This test helps diagnose and monitor these conditions.
This service was performed 28 times for 27 patientsA blood count, specifically hemoglobin, is a standard test that measures the amount of hemoglobin in your blood. Hemoglobin is a protein in red blood cells that carries oxygen throughout your body. This test helps assess your overall health and detect a variety of disorders such as anemia or polycythemia.
This service was performed 18 times for 17 patientsA blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.
This service was performed 11 times for 11 patientsA blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.
This service was performed 16 times for 15 patientsA blood potassium level test measures the amount of potassium in your blood. Potassium is a vital mineral for the body, helping nerves and muscles, especially the heart, to function properly. Abnormal levels can cause health issues like irregular heartbeat, muscle weakness, or numbness.
This service was performed 76 times for 61 patientsA basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.
This service was performed 2,904 times for 1,944 patientsA clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
This service was performed 1,132 times for 206 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 7,841 times for 6,083 patientsA lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
This service was performed 6,652 times for 5,393 patientsA TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
This service was performed 5,530 times for 4,292 patientsA total calcium level test measures the amount of calcium in your blood. Calcium is essential for body functions like bone formation, nerve signal transmission, and muscle contraction. Abnormal levels may indicate conditions like bone disease or kidney disorders.
This service was performed 16 times for 15 patientsA quantitative D-dimer test measures the amount of D-dimer, a protein fragment, in your blood. This test helps detect abnormal blood clotting. D-dimer levels can rise in conditions where clots are forming and breaking down, such as deep vein thrombosis or pulmonary embolism.
This service was performed 36 times for 34 patientsA complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
This service was performed 508 times for 444 patientsA Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
This service was performed 7,110 times for 5,322 patientsThe total Creatine Kinase (CK) level test is a blood test that helps assess the health of your heart. It measures an enzyme called CK that's released into the bloodstream when heart or other muscle tissue is damaged. High levels may indicate a heart attack or muscle disorder.
This service was performed 173 times for 146 patientsA creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.
This service was performed 312 times for 311 patientsA Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.
This service was performed 1,216 times for 1,082 patientsAn immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
This service was performed 22 times for 21 patientsThis test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
This service was performed 67 times for 67 patientsThis is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
This service was performed 22 times for 11 patientsA detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
This service was performed 46 times for 45 patientsA DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
This service was performed 106 times for 60 patientsThe "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.
This service was performed 744 times for 743 patientsA Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.
This service was performed 446 times for 382 patientsA Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.
This service was performed 213 times for 206 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 3,834 times for 2,752 patientsThe Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
This service was performed 142 times for 142 patientsThe quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.
This service was performed 13 times for 13 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 1,920 times for 1,406 patientsThis is your second dose of the COVID-19 vaccine, which is given via a shot into your muscle. The vaccine contains a tiny piece of the coronavirus's spike protein, which helps your body recognize and fight the virus. It's preservative-free and contains 100 mcg in a 0.5ml dose.
This service was performed 25 times for 25 patientsIron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.
This service was performed 475 times for 398 patientsAn iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.
This service was performed 551 times for 451 patientsA kidney function blood test panel checks how well your kidneys are working. It measures levels of various substances in your blood, including proteins, electrolytes, and waste products. The results can help detect potential kidney issues early.
This service was performed 104 times for 87 patientsA Lipase Level test measures the amount of lipase in your blood. Lipase is an enzyme that helps your body digest fats. High or low levels can indicate problems with your pancreas, such as pancreatitis or other conditions. This test helps your doctor diagnose and monitor these conditions.
This service was performed 81 times for 70 patientsA Liver Enzyme (SGOT) Level test is a simple blood test used to measure the amount of certain enzymes in your blood. These enzymes are normally found in liver cells. If the liver is damaged or diseased, these enzymes can leak into your bloodstream, indicating potential liver issues.
This service was performed 46 times for 42 patientsA liver enzyme (SGPT) level test is a blood test that checks the health of your liver. SGPT is an enzyme found in your liver cells. If your liver is damaged or inflamed, SGPT can leak into your bloodstream, raising the enzyme level. This test helps identify liver diseases early.
This service was performed 40 times for 36 patientsA liver function blood test panel helps check the health of your liver. It measures various proteins, liver enzymes, and bilirubin in your blood. If these levels are too high or too low, it could signal a liver problem. It's a simple, non-invasive test that involves drawing blood.
This service was performed 525 times for 304 patientsA magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.
This service was performed 581 times for 465 patientsA manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.
This service was performed 1,750 times for 1,337 patientsC-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.
This service was performed 280 times for 254 patientsA natriuretic peptide level test is a blood test that helps doctors check for heart failure. It measures the amount of certain proteins that your heart and blood vessels produce when they are under stress. High levels may indicate heart disease.
This service was performed 87 times for 75 patientsA phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.
This service was performed 49 times for 44 patientsProstate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.
This service was performed 987 times for 987 patientsPSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.
This service was performed 453 times for 424 patientsRed blood cell concentration measurement is a routine blood test that assesses the number of red blood cells in your blood. These cells carry oxygen throughout your body. The test can help identify conditions like anemia or dehydration. It's a simple, quick, and relatively painless procedure.
This service was performed 18 times for 17 patientsThe Red Blood Cell Sedimentation Rate is a test that helps detect inflammation in the body. It's automated, meaning a machine does the work. This test measures how fast red blood cells settle at the bottom of a tube in an hour. A faster rate may indicate inflammation.
This service was performed 300 times for 274 patientsA screening test for pathogenic organisms is a routine check-up procedure. It helps to identify harmful microorganisms in your body that can cause diseases. This involves collecting a sample like blood, saliva, or tissue, which is then examined in a lab for signs of these organisms.
This service was performed 180 times for 175 patientsA stool analysis for blood, or fecal hemoglobin determination by immunoassay, is a test that checks for hidden blood in your stool. This test helps identify potential issues in your digestive system. It involves collecting a small stool sample which is then analyzed in a lab for the presence of blood.
This service was performed 22 times for 20 patientsThe Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.
This service was performed 1,252 times for 993 patientsA Thyroxine (thyroid chemical) total test measures the amount of thyroxine, a hormone produced by your thyroid gland, in your blood. This hormone helps regulate your body's metabolism. The test can help diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism.
This service was performed 15 times for 15 patientsA transferrin level test measures the amount of transferrin, a protein that carries iron, in your blood. This can help determine if your body has an iron deficiency or overload. It's a simple blood test and can provide valuable information about your overall health.
This service was performed 37 times for 33 patientsA blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.
This service was performed 372 times for 322 patientsUrinalysis with a microscope is a test that helps detect issues in your body. A small sample of your urine is examined under a microscope. This allows the detection of substances not visible to the naked eye, aiding in diagnosing various health conditions.
This service was performed 16 times for 15 patientsThe urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.
This service was performed 1,001 times for 909 patientsA Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.
This service was performed 2,176 times for 1,799 patientsAn X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.
This service was performed 226 times for 111 patientsAn ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.
This service was performed 107 times for 56 patientsAn X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.
This service was performed 22 times for 11 patientsA chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
This service was performed 1,852 times for 816 patientsAn elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.
This service was performed 51 times for 27 patientsAn X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.
This service was performed 44 times for 23 patientsAn X-ray of the foot, 2 views, is a quick, painless test that produces images of the bones and structures inside your foot. Two different angles are used to provide a comprehensive view. This helps doctors diagnose fractures, infections, or other abnormalities.
This service was performed 57 times for 21 patientsAn X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
This service was performed 401 times for 173 patientsAn X-ray of the forearm, 2 views, is a diagnostic procedure where two different pictures of your forearm are taken using a small amount of radiation. These images help doctors assess your bone health and identify any fractures, infections, or other abnormalities.
This service was performed 34 times for 19 patientsAn X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.
This service was performed 111 times for 51 patientsAn X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
This service was performed 365 times for 179 patientsAn X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.
This service was performed 65 times for 26 patientsAn X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
This service was performed 311 times for 149 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
This service was performed 300 times for 152 patientsAn X-ray of the lower leg, 2 views, is a quick, painless test that produces images of the bones in your lower leg. It helps to identify fractures, infections, or diseases. Two different angles are used to provide a comprehensive view of the leg's structure.
This service was performed 53 times for 27 patientsAn X-ray of the middle spine, with 3 views, is a diagnostic procedure where images are taken from different angles (front, side, and angled) to assess the health of your spine. It helps identify issues like fractures, tumors, or degenerative conditions.
This service was performed 104 times for 54 patientsAn X-ray of the paranasal sinus involves taking multiple images of the spaces around your nose that produce mucus, aiding in clearing and moistening your nasal passages. This helps detect issues like infections, blockages, or abnormalities.
This service was performed 34 times for 17 patientsThis procedure involves taking two separate X-ray images of your ribs from different angles. It's a non-invasive test that helps visualize the bones and surrounding areas to detect any abnormalities or injuries. You'll be positioned carefully to capture the best images.
This service was performed 42 times for 22 patientsThis is a diagnostic procedure where a machine emits a small amount of radiation to capture images of your ribs from at least three different angles. It helps to identify issues like fractures or infections. It's a quick, painless process.
This service was performed 107 times for 55 patientsAn X-ray of the sacrum and tailbone involves capturing images of these lower spine areas from at least two different angles. This non-invasive procedure helps detect abnormalities or injuries, providing valuable information for accurate diagnosis and treatment.
This service was performed 33 times for 17 patientsAn X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
This service was performed 248 times for 122 patientsAn X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.
This service was performed 30 times for 17 patientsAn X-ray of the upper arm with a minimum of 2 views involves capturing images of your arm from different angles. This helps in assessing the bones and surrounding tissues for any abnormalities or injuries. It's a quick, painless procedure.
This service was performed 37 times for 19 patientsAn X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.
This service was performed 145 times for 74 patientsAn X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
This service was performed 116 times for 56 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.42 for a new patient copayment and $24.31 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 62521 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.71
- Minimum New Patient Price $54.8
- Maximum New Patient Price $168.44
- Average New Patient Copayment $21.42
- Minimum New Patient Copayment $13.7
- Maximum New Patient Copayment $42.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.25
- Minimum Established Patient Price $17.16
- Maximum Established Patient Price $136.56
- Average Established Patient Copayment $24.31
- Minimum Established Patient Copayment $4.29
- Maximum Established Patient Copayment $34.14
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.61, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 94.61 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 85.17
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1285643825, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285643825, enumerated as an "individual" on August 05, 2006.
The provider is located at 4965 E LOST BRIDGE RD DECATUR, IL 62521 and the phone number is (217) 864-5531.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health,. Please consult your insurance carrier or call the provider to verify.