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DR. HEIDI SUE MCLAUGHLIN M.D.
NPI 1396066536
Obstetrics & Gynecology in La Grange Highlands, IL

Active since June 22, 2010PECOS EnrolledAccepts Medicare Assignment
76.92/100
CMS Quality Rating
5201 WILLOW SPRINGS RD, STE 490, LA GRANGE HIGHLANDS, IL 60525(708) 352-4630 Get Directions Write a Review

NPPES record last updated: October 9, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Heidi Sue Mclaughlin M.d. NPPES

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

DR. HEIDI SUE MCLAUGHLIN M.D. (NPI 1396066536) is an individual obstetrics & gynecology provider in La Grange Highlands, Illinois, licensed in Missouri (2020017637) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS, is affiliated with Mosaic Life Care At St Joseph, and maintains a secondary practice location in Saint Joseph.

NPPES Registry Identity

NPI1396066536
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. HEIDI SUE MCLAUGHLINCredential: M.D.
Location Address5201 WILLOW SPRINGS RD, STE 490La Grange Highlands, IL 60525-6537
Mailing Address901 Heartland Rd Ste 2800Saint Joseph, MO 64506-6201 · (816) 271-1200 · Fax (816) 271-1220
Phone(708) 352-4630
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJune 22, 2010
Last NPPES UpdateOctober 9, 2020
NPPES CertifiedOctober 9, 2020
✔ NPI 1396066536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in MO · 2020017637✔ Licensed in IL · 036.137915
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
5201 WILLOW SPRINGS RD, La Grange Highlands, IL 60525
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Secondary Practice Location 1

Location 1901 Heartland Rd Ste 2800Saint Joseph, MO 64506 · Phone (816) 271-1200 · Fax (816) 271-1220

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.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. Heidi Sue Mclaughlin 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 ID1658688221
PECOS Enrollment IDI20200817001770
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 Reassignment

Medicare enrollment records show Heidi Mclaughlin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Heartland Regional Medical Center
387 mi
General Practice
5325 FARAON ST
Saint Joseph, MO 64506
  • Reassigned Medicare billing, Missouri enrollment
  • 471 clinicians in this Medicare group
NPI 1477575405 (816) 271-6000

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 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.
26 services22 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

Mosaic Life Care At St Joseph

Acute Care Hospitals · Saint Joseph, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260006
Location5325 Faraon StreetSaint Joseph, MO 64506 · Buchanan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60525 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
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.

76.92/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.53
Promoting Interoperability100
Improvement Activities40
Cost56.53

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.

ISABELLE VANMOON CHU MD
Surgery
5201 WILLOW SPRINGS RD
LA GRANGE HIGHLANDS, IL 60525
Cook County (630) 226-0664
SOHAIL QAMAR CSA
5201 WILLOW SPRINGS RD
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 579-0018
JAAFAR AFSHAR MD
Obstetrics & Gynecology
5201 WILLOW SPRINGS RD, 120
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 245-6097
BENJAMIN EYE CARE
Durable Medical Equipment & Medical Supplies
5201 WILLOW SPRINGS RD, SUITE 450
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 354-2008
BARBARA T BORGIONE PA-C
Physician Assistant
5201 WILLOW SPRINGS RD, SUITE 430
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 482-3213
DR. BRUCE DUANE FICK MD
Ophthalmology
5201 WILLOW SPRINGS RD, SUITE 450
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 354-2008
MRS. ALISON BAXTER GIUNTA M.S. PA-C
Physician Assistant (Surgical)
5201 WILLOW SPRINGS RD, #440
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 354-4667
ADVENTIST HEALTH PARTNERS, INC
Obstetrics & Gynecology
5201 WILLOW SPRINGS RD, SUITE 120
LA GRANGE HIGHLANDS, IL 60525
Cook County (708) 245-6097

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 Heidi Mclaughlin's NPI number?

The NPI number for Heidi Mclaughlin is 1396066536. It was assigned to this individual provider in the NPPES registry on June 22, 2010.

Where is Heidi Mclaughlin located?

Heidi Mclaughlin practices at 5201 Willow Springs Rd Ste 490, La Grange Highlands, IL 60525. The listed phone number is (708) 352-4630.

What is Heidi Mclaughlin's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Heidi Mclaughlin enrolled in Medicare?

Yes. Heidi Mclaughlin 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 organization bills Medicare for Heidi Mclaughlin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Heidi Mclaughlin reassigns Medicare benefits to Heartland Regional Medical Center (Saint Joseph, MO). The 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 Heidi Mclaughlin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Heidi Mclaughlin accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 4 other insurers list Heidi Mclaughlin 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 Heidi Mclaughlin affiliated with any hospitals?

According to CMS data, Heidi Mclaughlin is affiliated with Mosaic Life Care At St Joseph.

When was this NPI record last updated?

The NPPES record for Heidi Mclaughlin was last updated on October 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.