1. Home
  2. Directory
  3. Illinois
  4. Mount Vernon
  5. Internal Medicine
  6. NPI Profile

DR. ABDULMONAM AHMAD ABULGASEM ALI M.D.
NPI 1396026506
Internal Medicine - Pulmonary Disease in Mount Vernon, IL

Active since August 31, 2011PECOS EnrolledAccepts Medicare Assignment
4106 S WATER TOWER PL, MOUNT VERNON, IL 62864(618) 242-8900 Get Directions Write a Review

NPPES record last updated: July 19, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 19, 2023, Oct 17, 2022, Nov 16, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Abdulmonam Ahmad Abulgasem Ali M.d. NPPES

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

DR. ABDULMONAM AHMAD ABULGASEM ALI M.D. (NPI 1396026506) is an individual pulmonary disease provider in Mount Vernon, Illinois, licensed in Wisconsin (1721) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1396026506
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. ABDULMONAM AHMAD ABULGASEM ALICredential: M.D.
Location Address4106 S WATER TOWER PLMount Vernon, IL 62864-6544
Mailing Address4501 Hammerbersly Rd Apt 10gMadison, WI 53711
Phone(618) 242-8900
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateAugust 31, 2011
Last NPPES UpdateJuly 19, 20234 updates tracked since enumeration
NPPES CertifiedJuly 14, 2023
✔ NPI 1396026506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses✔ Licensed in WI · 1721✔ Licensed in IL · 036.142644
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 1721 (WI), 036142644 (IL)
4106 S WATER TOWER PL, Mount Vernon, IL 62864
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1600 Highland AveMadison, WI 53792-6544 · Phone (608) 263-7203
Location 22 Good Samaritan Way Ste 420Mount Vernon, IL 62864-2478 · Phone (618) 899-4000
Location 32300 N Edward StDecatur, IL 62526-4163 · Phone (217) 876-4200 · Fax (217) 876-4209

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Abdulmonam Ahmad Abulgasem Ali 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 ID4082918263
PECOS Enrollment IDI20170613000176
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Abdulmonam Ali reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Good Samaritan Regional Health Center
0.7 mi
Specialist
1 GOOD SAMARITAN WAY
Mount Vernon, IL 62864
  • Reassigned Medicare billing, Illinois enrollment
  • 284 clinicians in this Medicare group
NPI 1134457955 (618) 899-4600
Physician Services Corporation Of Southern Illinois Inc.
0.8 mi
Internal Medicine
4218 LINCOLNSHIRE DR
Mount Vernon, IL 62864
  • Reassigned Medicare billing, Illinois enrollment
  • 296 clinicians in this Medicare group
NPI 1831101807 (618) 899-3600
St. Mary's Hospital, Centralia, Illinois
18 mi
Anesthesiology
400 N PLEASANT AVE
Centralia, IL 62801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: St Marys Hospital Centralia Illinois
  • 392 clinicians in this Medicare group
NPI 1477097871 (618) 436-6056
County Of Clay
36 mi
Critical Access
911 STACEY BURK DR
Flora, IL 62839
  • Reassigned Medicare billing, Illinois enrollment
  • 110 clinicians in this Medicare group
NPI 1184655136 (618) 662-2131

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
156 services66 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
63 services63 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
62 services62 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
61 services61 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
61 services61 patients
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.
59 services53 patients

Hospital Affiliations CMS Care Compare 4

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

Pinckneyville Community Hospital

Critical Access Hospitals · Pinckneyville, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141307
Location5383 State Route 154Pinckneyville, IL 62274 · Perry 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 62864 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
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 17

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
4 suppliers24 claims48 services$1.67 avg. paid by Medicare
Tracheostomy mask, each A7525
DME-Orthotic Devices · category DF000N
1 supplier11 claims22 services$1.99 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
2 suppliers34 claims34 services$20.42 avg. paid by Medicare
Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443
DME-Oxygen and Supplies · category DC000N
2 suppliers14 claims16 services$52.91 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
3 suppliers72 claims72 services$914.25 avg. paid by Medicare
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470
DME-Other DME · category DE001N
1 supplier12 claims12 services$127.20 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Abdulmonam Ali's NPI number?

The NPI number for Abdulmonam Ali is 1396026506. It was assigned to this individual provider in the NPPES registry on August 31, 2011.

Where is Abdulmonam Ali located?

Abdulmonam Ali practices at 4106 S Water Tower Pl, Mount Vernon, IL 62864. The listed phone number is (618) 242-8900.

What is Abdulmonam Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Abdulmonam Ali enrolled in Medicare?

Yes. Abdulmonam Ali 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.

Which organizations bill Medicare for Abdulmonam Ali's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Abdulmonam Ali reassigns Medicare benefits to 4 organizations: Good Samaritan Regional Health Center (Mount Vernon, IL), Physician Services Corporation Of Southern Illinois Inc. (Mount Vernon, IL), St. Mary's Hospital, Centralia, Illinois (Centralia, IL) and County Of Clay (Flora, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Abdulmonam Ali's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Abdulmonam Ali accept?

Health plans from CareSource list Abdulmonam Ali 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 Abdulmonam Ali affiliated with any hospitals?

According to CMS data, Abdulmonam Ali is affiliated with Ssm Health St Mary's Hospital -Centralia, Good Samaritan Regional Hlth Center, Pinckneyville Community Hospital and Salem Township Hospital.

When was this NPI record last updated?

The NPPES record for Abdulmonam Ali was last updated on July 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.