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DR. AHMED A. RADWAN M.D.
NPI 1376575126
Family Medicine - Sports Medicine in O Fallon, IL

Active since July 06, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
670 PIERCE BLVD, O FALLON, IL 62269(618) 206-2070(618) 206-2071 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Ahmed A. Radwan M.d. NPPES

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

DR. AHMED A. RADWAN M.D. (NPI 1376575126) is an individual sports medicine provider in O Fallon, Illinois, licensed in Illinois (036114529) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1376575126
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameDR. AHMED A. RADWANCredential: M.D.
Location Address670 PIERCE BLVDO Fallon, IL 62269-2579
Mailing Address1512 N Green Mount Rd, Suite 200O Fallon, IL 62269-1953 · (618) 624-1860 · Fax (618) 624-1863
Phone(618) 206-2070
Fax(618) 206-2071
Sole ProprietorYes
Medical School CMSOtherGraduated 1994
Enumeration DateJuly 6, 2006
Last NPPES UpdateDecember 30, 2021
NPPES CertifiedDecember 30, 2021
✔ NPI 1376575126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in IL · 036114529
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
670 PIERCE BLVD, O Fallon, IL 62269
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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 and more.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. Ahmed A. Radwan M.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 ID547268476
PECOS Enrollment IDI20061201000037
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 8

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.
296 services113 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
284 services29 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
99 services70 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
39 services22 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.
19 services19 patients
Administration of influenza virus vaccine G0008
The 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.
18 services18 patients

Hospital Affiliations CMS Care Compare 5

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

St Marys Hospital

Acute Care Hospitals · Decatur, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140166
Location1800 E Lake Shore DrDecatur, IL 62521 · Macon 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

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260032
LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62269 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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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 suppliers18 claims60 services$5.26 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 13

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

MRS. AMY MARIE BUCK APN
Nurse Practitioner (Family)
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2070
MICHAEL J HOHM PA-C
Physician Assistant
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094
MRS. KIMBERLY BURGESS AGNP-C
Nurse Practitioner
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094
MRS. RICKI LOAR APN
Nurse Practitioner (Family)
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094
ANDRES LERNER MD
Orthopaedic Surgery (Hand Surgery)
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094
KODY ALAN HINDMAN
Physician Assistant
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094
DR. RICHARD DERBY MD
Family Medicine (Sports Medicine)
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094
SHAELIN HEIMAN PA-C
Physician Assistant
670 PIERCE BLVD
O FALLON, IL 62269
St. Clair County (618) 206-2094

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 Ahmed Radwan's NPI number?

The NPI number for Ahmed Radwan is 1376575126. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Ahmed Radwan located?

Ahmed Radwan practices at 670 Pierce Blvd, O Fallon, IL 62269. The listed phone number is (618) 206-2070.

What is Ahmed Radwan's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Ahmed Radwan enrolled in Medicare?

Yes. Ahmed Radwan 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 Ahmed Radwan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Blue Cross and Blue Shield of Kansas, Inc. and UnitedHealthcare list Ahmed Radwan 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 Ahmed Radwan affiliated with any hospitals?

According to CMS data, Ahmed Radwan is affiliated with St Johns Hospital, St Marys Hospital, Memorial Hospital, Hshs St Elizabeth's Hospital and Barnes Jewish Hospital.

When was this NPI record last updated?

The NPPES record for Ahmed Radwan was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.