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DR. HENRY PURCELL M.D.
NPI 1467530410
Internal Medicine - Nephrology in Maryville, IL

Active since November 01, 2006PECOS EnrolledAccepts Medicare Assignment
74.42/100
CMS Quality Rating
6812 STATE ROUTE 162 STE 121, MARYVILLE, IL 62062(618) 391-6910 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Henry Purcell M.d. NPPES

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

DR. HENRY PURCELL M.D. (NPI 1467530410) is an individual nephrology provider in Maryville, Illinois, licensed in Missouri (R9H62) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Gateway Regional Medical Center, and is a graduate of Saint Louis University School Of Medicine (1984).

NPPES Registry Identity

NPI1467530410
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. HENRY PURCELLCredential: M.D.
Location Address6812 STATE ROUTE 162 STE 121Maryville, IL 62062-8586
Mailing AddressPo Box 797021Saint Louis, MO 63179-7000 · (314) 644-3535 · Fax (314) 644-3255
Phone(618) 391-6910
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 1984
Enumeration DateNovember 1, 2006
Last NPPES UpdateSeptember 10, 2024
NPPES CertifiedSeptember 10, 2024
✔ NPI 1467530410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in MO · R9H62
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
6812 STATE ROUTE 162 STE 121, Maryville, IL 62062
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Other Identifiers 1

Other110165961MO · Railroad Medicare

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

Dr. Henry Purcell 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 ID3375450257
PECOS Enrollment IDI20071215000117, I20080110000671
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 11

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.
377 services216 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
261 services105 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
247 services35 patients
Home dialysis services per month (20 years or older) 90966
Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
165 services18 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
147 services45 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.
67 services56 patients

Hospital Affiliations CMS Care Compare 5

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

Gateway Regional Medical Center

Acute Care Hospitals · Granite City, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140125
Location2100 Madison AvenueGranite City, IL 62040 · Madison County
Emergency services

Hshs Holy Family Hospital Inc

Acute Care Hospitals · Greenville, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140137
Location200 Health Care DrGreenville, IL 62246 · Bond County
Emergency services

Anderson Hospital

Acute Care Hospitals · Maryville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140289
Location6800 State Route 162Maryville, IL 62062 · Madison County
Emergency services Birthing friendly

Community Hospital Of Staunton

Critical Access Hospitals · Staunton, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141306
Location400 N Caldwell StStaunton, IL 62088 · Macoupin County
Emergency services

St Joseph's Hospital

Critical Access Hospitals · Highland, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number141336
Location12866 Troxler AvenueHighland, IL 62249 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
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.

74.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.31
Promoting Interoperability85
Improvement Activities40
Cost56.92

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
96%595 patients4/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
99%225 patients5/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
55%1,824 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%835 patients5/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
91%33 patients4/55-star benchmark: 96%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
80%1,055 patients4/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
93%592 patients5/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
85%857 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
64%1,079 patients3/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 99% · 609 patients
100%609 patients
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
85%1,055 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,055 patients1/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 595 patients
0%595 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

SRIRAJ T. KANUNGO M.D.
Internal Medicine (Nephrology)
6812 STATE ROUTE 162 STE 121
MARYVILLE, IL 62062
Madison County (618) 391-5690

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 Henry Purcell's NPI number?

The NPI number for Henry Purcell is 1467530410. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Henry Purcell located?

Henry Purcell practices at 6812 State Route 162 Ste 121, Maryville, IL 62062. The listed phone number is (618) 391-6910.

What is Henry Purcell's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Henry Purcell enrolled in Medicare?

Yes. Henry Purcell 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 Henry Purcell accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Henry Purcell 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 Henry Purcell affiliated with any hospitals?

According to CMS data, Henry Purcell is affiliated with Gateway Regional Medical Center, Hshs Holy Family Hospital Inc, Anderson Hospital, Community Hospital Of Staunton and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Henry Purcell was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.