AMY MCLAIN APN
NPI 1487197034
Nurse Practitioner in Decatur, IL

Active since November 30, 2016PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
4965 E LOST BRIDGE RD, DECATUR, IL 62521(217) 864-5531(217) 864-2449 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2022, May 12, 2022, Feb 9, 2022 and 1 more (4 updates tracked since 2018).

About Amy Mclain Apn NPPES

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

AMY MCLAIN APN (NPI 1487197034) is an individual nurse practitioner in Decatur, Illinois, licensed in Illinois (209015064) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1487197034
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameAMY MCLAINCredential: APN
Location Address4965 E LOST BRIDGE RDDecatur, IL 62521-5139
Mailing Address3051 Hollis DrSpringfield, IL 62704-7450 · (217) 492-9695
Fax(217) 864-2449
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 30, 2016
Last NPPES UpdateAugust 19, 20224 updates tracked since enumeration
NPPES CertifiedAugust 19, 2022
NPI 1487197034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in IL · 209015064
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
4965 E LOST BRIDGE RD, Decatur, IL 62521

Accepted 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

Amy Mclain Apn 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 ID9335419662
PECOS Enrollment IDI20170719003651
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 12

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.
335 services213 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.
332 services195 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.
174 services126 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
145 services125 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
50 services41 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
27 services27 patients

Hospital Affiliations CMS Care Compare 3

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140135
Location2300 North Edward StreetDecatur, IL 62526 · Macon County
Emergency services Birthing friendly

St Marys Hospital

Acute Care Hospitals · Decatur, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140166
Location1800 E Lake Shore DrDecatur, IL 62521 · Macon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62521 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.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 8

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

Family Medicine
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Family Medicine
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Nurse Practitioner
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Family Medicine
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Nurse Practitioner (Family)
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Family Medicine
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Family Medicine
4965 E LOST BRIDGE RD
DECATUR, IL 62521
Physician Assistant
4965 E LOST BRIDGE RD
DECATUR, IL 62521

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 Amy Mclain's NPI number?

The NPI number for Amy Mclain is 1487197034. It was assigned to this individual provider in the NPPES registry on November 30, 2016.

Where is Amy Mclain located?

Amy Mclain practices at 4965 E Lost Bridge Rd, Decatur, IL 62521. The listed phone number is (217) 864-5531.

What is Amy Mclain's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Amy Mclain enrolled in Medicare?

Yes. Amy Mclain 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 Amy Mclain accept?

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

According to CMS data, Amy Mclain is affiliated with St Johns Hospital, Decatur Memorial Hospital and St Marys Hospital.

When was this NPI record last updated?

The NPPES record for Amy Mclain was last updated on August 19, 2022. 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.