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KRISTI M TOENNIES NP
NPI 1366467755
Nurse Practitioner in Decatur, IL

Active since July 13, 2006PECOS EnrolledAccepts Medicare Assignment
77.67/100
CMS Quality Rating
210 W. MCKINLEY AVE, STE 1, DECATUR, IL 62526(217) 876-6600(217) 876-6606 Get Directions Write a Review

NPPES record last updated: April 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kristi M Toennies Np NPPES

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

KRISTI M TOENNIES NP (NPI 1366467755) is an individual nurse practitioner in Decatur, Illinois, licensed in Missouri (137122) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1366467755
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKRISTI M TOENNIESCredential: NP
Location Address210 W. MCKINLEY AVE, STE 1Decatur, IL 62526
Mailing Address1052 Martin Luther King Dr, Suite 2Centralia, IL 62801-3002 · (618) 436-5410 · Fax (618) 436-8063
Phone(217) 876-6600
Fax(217) 876-6606
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJuly 13, 2006
Last NPPES UpdateApril 29, 2015
✔ NPI 1366467755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MO · 137122
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
210 W. MCKINLEY AVE, Decatur, IL 62526
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINP38696
Medicare PINK47991
Medicaid209004197IL
Medicare NSC0970490001

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

Kristi M Toennies Np 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 ID3577567296
PECOS Enrollment IDI20060911000443
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 2

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.
782 services425 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.
61 services42 patients

Hospital Affiliations CMS Care Compare 5

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

Ssm Health St Mary's Hospital -Centralia

Acute Care Hospitals · Centralia, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140034
Location400 North Pleasant AvenueCentralia, IL 62801 · Marion County
Emergency services

Good Samaritan Regional Hlth Center

Acute Care Hospitals · Mount Vernon, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140046
Location1 Good Samaritan WayMount Vernon, IL 62864 · Jefferson County
Emergency services Birthing friendly

St Josephs Hospital

Acute Care Hospitals · Breese, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140145
Location9515 Holy Cross LnBreese, IL 62230 · Clinton County
Emergency services Birthing friendly

Fairfield Memorial Hospital 1

Critical Access Hospitals · Fairfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number141311
Location303 N W 11th StreetFairfield, IL 62837 · Wayne County
Emergency services

Salem Township Hospital

Critical Access Hospitals · Salem, IL
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number141345
Location1201 Ricker DriveSalem, IL 62881 · Marion County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

77.67/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.39
Promoting Interoperability83
Improvement Activities40
Cost52.7

Other Providers at the Same Location NPPES 4

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

DOLORES A ESTRADA-GARCIA MD
Internal Medicine (Hematology & Oncology)
210 W. MCKINLEY AVE, SUITE 1
DECATUR, IL 62526
Macon County (217) 876-6600
MRS. MARY ANNE DEPAZ MD
Radiology (Radiation Oncology)
210 W. MCKINLEY AVE, STE 2
DECATUR, IL 62526
Macon County (217) 876-6600
MR. EDWARD C ELLIOTT II MD
Radiology (Radiation Oncology)
210 W. MCKINLEY AVE, STE 1
DECATUR, IL 62526
Macon County (217) 876-6600
JAMES L WADE III M.D.
Internal Medicine (Medical Oncology)
210 W. MCKINLEY AVE, STE 1
DECATUR, IL 62526
Macon County (217) 876-6600

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 Kristi Toennies's NPI number?

The NPI number for Kristi Toennies is 1366467755. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Kristi Toennies located?

Kristi Toennies practices at 210 W. Mckinley Ave Ste 1, Decatur, IL 62526. The listed phone number is (217) 876-6600.

What is Kristi Toennies's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kristi Toennies enrolled in Medicare?

Yes. Kristi Toennies 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 Kristi Toennies accept?

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

According to CMS data, Kristi Toennies is affiliated with Ssm Health St Mary's Hospital -Centralia, Good Samaritan Regional Hlth Center, St Josephs Hospital, Fairfield Memorial Hospital 1 and Salem Township Hospital.

When was this NPI record last updated?

The NPPES record for Kristi Toennies was last updated on April 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.