DR. JOHN P. OPILKA D.O.
NPI 1497715056
Family Medicine in Altamont, IL
About Dr. John P. Opilka D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN P. OPILKA D.O. (NPI 1497715056) is an individual family medicine provider in Altamont, Illinois, licensed in Illinois (036099320) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and is a graduate of Other (1996).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 7
Accepted 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. John P. Opilka D.o. 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.
Medicare Billing Reassignments
2Medicare enrollment records show John Opilka reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Effingham, IL 62401
- Reassigned Medicare billing, Illinois enrollment
- 104 clinicians in this Medicare group
Vandalia, IL 62471
- Reassigned Medicare billing, Illinois enrollment
- 652 clinicians in this Medicare group
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 27
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Anthonys Memorial Hospital
Acute Care Hospitals · Effingham, ILSarah Bush Lincoln Health Center
Acute Care Hospitals · Mattoon, ILFayette County Hospital
Critical Access Hospitals · Vandalia, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62411 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Referred Medical Equipment & Supplies CMS DME claims 34
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ALTAMONT, IL 62411
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 John Opilka's NPI number?
The NPI number for John Opilka is 1497715056. It was assigned to this individual provider in the NPPES registry on March 27, 2006.
Where is John Opilka located?
John Opilka practices at 5 E Cumberland Rd, Altamont, IL 62411. The listed phone number is (618) 483-6151.
What is John Opilka's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is John Opilka enrolled in Medicare?
Yes. John Opilka 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 John Opilka's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Opilka reassigns Medicare benefits to 2 organizations: St Anthonys Memorial Hospital Of The Hospital Sisters Of The Third (Effingham, IL) and Sarah Bush Lincoln Health Center (Vandalia, 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 John Opilka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Opilka accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list John Opilka 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 John Opilka affiliated with any hospitals?
According to CMS data, John Opilka is affiliated with St Anthonys Memorial Hospital, Sarah Bush Lincoln Health Center and Fayette County Hospital.
When was this NPI record last updated?
The NPPES record for John Opilka was last updated on April 6, 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.