ERIC DEAN LOPATIN MD
NPI 1356381271
Family Medicine in Troy, IL

Active since June 08, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 14D0860855 · Microscopy
74.42/100
CMS Quality Rating
301 EDWARDSVILLE ROAD, TROY, IL 62294(618) 667-7057(618) 667-8131 Get Directions Write a Review

NPPES record last updated: February 11, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eric Dean Lopatin Md NPPES

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

ERIC DEAN LOPATIN MD (NPI 1356381271) is an individual family medicine provider in Troy, Illinois, licensed in Illinois (036075388) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Microscopy certificate valid through August 31, 2026, and is affiliated with Anderson Hospital.

NPPES Registry Identity

NPI1356381271
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameERIC DEAN LOPATINCredential: MD
Location Address301 EDWARDSVILLE ROADTroy, IL 62294
Mailing Address301 Edwardsville RoadTroy, IL 62294 · (618) 667-7057 · Fax (618) 667-8131
Fax(618) 667-8131
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1984
Enumeration DateJune 8, 2006
Last NPPES UpdateFebruary 11, 2010
NPI 1356381271 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 · 036075388
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.
301 EDWARDSVILLE ROAD, Troy, IL 62294

Other Identifiers 3

Medicaid036075388IL
Medicare UPINC48970
Medicare ID-Type Unspecified212777

Accepted 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

Eric Dean Lopatin Md 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 ID5597787838
PECOS Enrollment IDI20051229000562
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 14D0860855

Eric Lopatin MD · Troy, IL
Active · expires Aug 31, 2026
CLIA Number14D0860855
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorEric D. Lopatin
Laboratory Phone(618) 667-7057
Laboratory LocationEric Lopatin MD301 Edwardsville Road, Troy, IL 62294
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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.
231 services135 patients
Insertion of needle into vein for collection of blood sample 36415
This 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.
203 services124 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.
63 services51 patients

Hospital Affiliations CMS Care Compare

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

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62294 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
Quality70.31
Promoting Interoperability85
Improvement Activities40
Cost56.92

Referred Medical Equipment & Supplies CMS DME claims 5

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
7 suppliers15 claims48 services$4.93 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers20 claims24 services$1.04 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$15.77 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$70.05 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
3 suppliers13 claims14 services$178.80 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 2

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

Family Medicine
301 EDWARDSVILLE ROAD
TROY, IL 62294
Family Medicine
301 EDWARDSVILLE ROAD
TROY, IL 62294

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 Eric Lopatin's NPI number?

The NPI number for Eric Lopatin is 1356381271. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Where is Eric Lopatin located?

Eric Lopatin practices at 301 Edwardsville Road, Troy, IL 62294. The listed phone number is (618) 667-7057.

What is Eric Lopatin's specialty?

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

Is Eric Lopatin enrolled in Medicare?

Yes. Eric Lopatin 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.

Does Eric Lopatin hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D0860855) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Eric Lopatin accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Eric Lopatin 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 Eric Lopatin affiliated with any hospitals?

According to CMS data, Eric Lopatin is affiliated with Anderson Hospital.

When was this NPI record last updated?

The NPPES record for Eric Lopatin was last updated on February 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.