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RUSSELL COULTER MD
NPI 1548227606
Family Medicine in Sparta, IL

Active since May 01, 2006PECOS EnrolledAccepts Medicare Assignment
95.01/100
CMS Quality Rating
FAMILY HEALTH CENTRE, 207 SOUTH BURNS AVE, SPARTA, IL 62286(618) 443-3084 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 29, 2026, Jun 4, 2020, May 20, 2020 (3 updates tracked since 2020).

About Russell Coulter Md NPPES

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

RUSSELL COULTER MD (NPI 1548227606) is an individual family medicine provider in Sparta, Illinois, licensed in Illinois (036064147) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Sparta Community Hospital, and maintains a secondary practice location in Sparta.

NPPES Registry Identity

NPI1548227606
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRUSSELL COULTERCredential: MD
Location AddressFAMILY HEALTH CENTRE, 207 SOUTH BURNS AVESparta, IL 62286
Mailing Address818 E Broadway StSparta, IL 62286-1820 · (618) 443-2177 · Fax (618) 443-1380
Phone(618) 443-3084
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateMay 1, 2006
Last NPPES UpdateMay 29, 20263 updates tracked since enumeration
NPPES CertifiedMay 29, 2026
✔ NPI 1548227606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036064147
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

FAMILY HEALTH CENTRE, Sparta, IL 62286
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Secondary Practice Location 1

Location 1818 E Broadway StSparta, IL 62286-1820 · Phone (618) 443-2177 · Fax (618) 443-1380

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

Russell Coulter Md 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 ID3870515661
PECOS Enrollment IDI20060314000618
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 7

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.

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.
255 services80 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
136 services112 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
111 services94 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
34 services15 patients
Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes 99235
This service involves a brief hospital stay for a moderate health issue. You'll be admitted and discharged on the same day, typically within 50 minutes. It's a quick, efficient way to receive necessary care and medical attention.
34 services34 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
28 services27 patients

Hospital Affiliations CMS Care Compare

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

Sparta Community Hospital

Critical Access Hospitals · Sparta, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141349
Location818 E BroadwaySparta, IL 62286 · Randolph County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62286 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
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.

95.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.02
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers23 claims49 services$6.56 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
1 supplier11 claims660 services$1.47 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers15 claims15 services$105.41 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Russell Coulter's NPI number?

The NPI number for Russell Coulter is 1548227606. It was assigned to this individual provider in the NPPES registry on May 1, 2006.

Where is Russell Coulter located?

Russell Coulter practices at Family Health Centre 207 South Burns Ave, Sparta, IL 62286. The listed phone number is (618) 443-3084.

What is Russell Coulter's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Russell Coulter enrolled in Medicare?

Yes. Russell Coulter 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.

Is Russell Coulter affiliated with any hospitals?

According to CMS data, Russell Coulter is affiliated with Sparta Community Hospital.

When was this NPI record last updated?

The NPPES record for Russell Coulter was last updated on May 29, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.