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KELLY M WHITAKER NP
NPI 1386932028
Nurse Practitioner - Adult Health in Mascoutah, IL

Active since July 15, 2011PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
124 W MAIN ST, MASCOUTAH, IL 62258(186) 402-5572(636) 333-4510 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 19, 2024, Oct 14, 2016 (2 updates tracked since 2016).

About Kelly M Whitaker Np NPPES

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

KELLY M WHITAKER NP (NPI 1386932028) is an individual adult health provider in Mascoutah, Illinois, licensed in Illinois (277.000945) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1386932028
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameKELLY M WHITAKERCredential: NP
Location Address124 W MAIN STMascoutah, IL 62258-2039
Mailing AddressPo Box 303Mascoutah, IL 62258-0303 · (618) 792-3586
Phone(186) 402-5572
Fax(636) 333-4510
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 15, 2011
Last NPPES UpdateNovember 19, 20242 updates tracked since enumeration
NPPES CertifiedNovember 18, 2024
✔ NPI 1386932028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in IL · 277.000945
124 W MAIN ST, Mascoutah, IL 62258
Open in Google Maps ↗

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

Kelly M Whitaker 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 ID3476723966
PECOS Enrollment IDI20110818000568
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 13

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.

Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
1,632 services661 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
273 services82 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
268 services65 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
214 services96 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
210 services64 patients
Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99341
A new patient home visit is a brief, 20-minute appointment where a healthcare professional comes to your home. This visit is to understand your health needs, answer your queries, and plan your care. It's a convenient way to start your healthcare journey.
145 services145 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62258 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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier12 claims12 services$68.39 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

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

MRS. MYKALE R ELBE FNP
Nurse Practitioner (Family)
124 W MAIN ST
MASCOUTAH, IL 62258
St. Clair County (618) 792-8537

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 Kelly Whitaker's NPI number?

The NPI number for Kelly Whitaker is 1386932028. It was assigned to this individual provider in the NPPES registry on July 15, 2011.

Where is Kelly Whitaker located?

Kelly Whitaker practices at 124 W Main St, Mascoutah, IL 62258. The listed phone number is (186) 402-5572.

What is Kelly Whitaker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Kelly Whitaker enrolled in Medicare?

Yes. Kelly Whitaker 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 Kelly Whitaker accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Kelly Whitaker 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.

When was this NPI record last updated?

The NPPES record for Kelly Whitaker was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.