DR. PAUL ALAN CONRAD MD FACS
NPI 1528028214
Otolaryngology in Quincy, IL

Q: What is the provider's specialty?

The provider's specialty is Otolaryngology with taxonomy code 207Y00000X.

Active since March 25, 2006PECOS EnrolledAccepts Medicare Assignment

1025 MAINE ST, QUINCY, IL 62301(217) 222-6550 Get Directions Write a Review

NPPES record last updated: July 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 25, 2024, Jul 28, 2021 (2 updates tracked since 2021).

Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 36
Otolaryngology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About PAUL CONRAD

This page provides the complete NPI Profile along with additional information for Paul Conrad, a provider established in Quincy, Illinois with a medical specialization in Otolaryngology and more than 36 years of experience. He graduated from Indiana University School Of Medicine in 1991. The healthcare provider is registered in the NPI registry with number 1528028214 assigned on March 2006. The practitioner's primary taxonomy code is 207Y00000X with license number 036092494 (IL). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI: 1528028214 Verify this NPI
Provider Name: DR. PAUL ALAN CONRAD MD FACS
Gender: Male
Entity Type: Individual
Location Address: 1025 MAINE ST QUINCY, IL 62301
Location Phone: (217) 222-6550
Mailing Address: 1025 MAINE ST QUINCY, IL 62301
Mailing Phone: (217) 222-6550
Medical School Name: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year: 1991
Is Sole Proprietor?: No
Enumeration Date: 03-25-2006
Last Update Date: 07-25-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Otolaryngology
Taxonomy Code: 207Y00000X
Type: Allopathic & Osteopathic Physicians
License No.: 036092494
License State: IL
Taxonomy Description: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

CareSource

Bronze 7500 $25 Generic Drugs - HMO
Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
Core Gold 1500 $10 Generic Drugs - HMO
Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Gold 2000 $15 Generic Drugs - HMO
Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Low Premium Bronze 10600 $25 Generic Drugs - HMO
Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
Low Premium Silver 6200 $3 Generic Drugs - HMO
Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
Silver 6000 $20 Generic Drugs - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
UHC Bronze Essential (No Referrals) - EPO
UHC Bronze Standard (No Referrals) - EPO
UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - EPO
UHC Gold Standard (No Referrals) - EPO
UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
UHC Silver Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
UHC Silver Standard (No Referrals) - EPO
UHC Silver Standard+ (Dental + Vision, No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Paul Conrad is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Paul Conrad is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 648268052
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20210525002812, I20221018001881
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy or removal of nasal polyp or tissue using an endoscope
Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Exam of ear using a microscope
Fine needle aspiration biopsy using ultrasound guidance, first growth
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
Removal of impacted ear wax
Test to assess middle ear function

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.86 for a new patient copayment and $17.16 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 62301 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $127.46
Minimum New Patient Price $54.8
Maximum New Patient Price $168.44

Average New Patient Copayment $31.86
Minimum New Patient Copayment $13.7
Maximum New Patient Copayment $42.11

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $68.64
Minimum Established Patient Price $17.16
Maximum Established Patient Price $136.56

Average Established Patient Copayment $17.16
Minimum Established Patient Copayment $4.29
Maximum Established Patient Copayment $34.14

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Breast Cancer Screening	1%	277
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement	Yes	N/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Colorectal Cancer Screening	23%	486
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
e-Prescribing	88%	500
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Medication Reconciliation	98%	154
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	85%	477
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.
Provide Patient Access	99%	477
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 certain information.
Secure Messaging	15%	477
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Syndromic Surveillance Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_2_MULTI.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Paul Conrad is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
BLESSING HOSPITAL	1005 BROADWAY ST QUINCY, IL 62301	(217) 223-1200	Acute Care Hospitals
NORTHEAST REGIONAL MEDICAL CENTER	315 S OSTEOPATHY KIRKSVILLE, MO 63501	(660) 785-1000	Acute Care Hospitals
PIKE COUNTY MEMORIAL HOSPITAL	2305 WEST GEORGIA STREET LOUISIANA, MO 63353	(573) 754-5531	Critical Access Hospitals