CARLOS MIGUEL AVILA M.D.
NPI 1386059624
Family Medicine in Springfield, IL

Q: What is Carlos Avila's NPI number?

The NPI number for Carlos Avila is 1386059624. It was assigned to this individual provider in the NPPES registry on June 25, 2014.

Q: What is Carlos Avila's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Carlos Avila was last updated on June 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since June 25, 2014PECOS EnrolledAccepts Medicare Assignment

520 N 4TH ST, SPRINGFIELD, IL 62702(217) 757-8100(217) 757-8161 Get Directions Write a Review

NPPES record last updated: June 25, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Carlos Miguel Avila M.d. NPPES

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

CARLOS MIGUEL AVILA M.D. (NPI 1386059624) is an individual family medicine provider in Springfield, Illinois, licensed in Illinois (125.065885) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Hammond Henry Hospital, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1386059624

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameCARLOS MIGUEL AVILACredential: M.D.

Location Address520 N 4TH STSpringfield, IL 62702-5238

Mailing Address520 N 4th StSpringfield, IL 62702-5238 · (217) 757-8100 · Fax (217) 757-8161

Phone(217) 757-8100

Fax(217) 757-8161

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJune 25, 2014

✔ NPI 1386059624 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 · 125.065885

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.

520 N 4TH ST, Springfield, IL 62702

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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

Carlos Miguel Avila 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 ID9133345762

PECOS Enrollment IDI20160927000248

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 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.

74 services59 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.

62 services58 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.

14 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Hammond Henry Hospital

Critical Access Hospitals · Geneseo, IL

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141319

Location600 N College AvenueGeneseo, IL 61254 · Henry County

Emergency services

Osf Saint Luke Medical Center

Critical Access Hospitals · Kewanee, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141325

Location1051 West South StreetKewanee, IL 61443 · Henry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 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.

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

3 suppliers20 claims40 services$3.63 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 20

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

MRS. AMANDA B HENSON LCSW

Social Worker (Clinical)