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CAROLYN MACIAS FNP-C
NPI 1548994247
Nurse Practitioner - Family in Bourbonnais, IL

Active since July 11, 2022PECOS EnrolledAccepts Medicare Assignment
656 N CONVENT ST STE C, BOURBONNAIS, IL 60914(815) 936-5167 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 5, 2025, Jul 11, 2022 (2 updates tracked since 2022).

About Carolyn Macias Fnp-c NPPES

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

CAROLYN MACIAS FNP-C (NPI 1548994247) is an individual family provider in Bourbonnais, Illinois, licensed in Illinois (209025337) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Presence St Marys Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1548994247
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCAROLYN MACIASCredential: FNP-C
Location Address656 N CONVENT ST STE CBourbonnais, IL 60914-1393
Mailing Address656 N Convent St Ste CBourbonnais, IL 60914-1393 · (815) 936-5167
Phone(815) 936-5167
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 11, 2022
Last NPPES UpdateMarch 5, 20252 updates tracked since enumeration
NPPES CertifiedMarch 5, 2025
✔ NPI 1548994247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209025337
656 N CONVENT ST STE C, Bourbonnais, IL 60914
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Carolyn Macias Fnp-c 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 ID1355723321
PECOS Enrollment IDI20220808001996
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Carolyn Macias reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Midwest Express Care 2, Inc
41 mi
Urgent Care
40 75TH ST
Willowbrook, IL 60527
  • Reassigned Medicare billing, Illinois enrollment
  • 410 clinicians in this Medicare group
NPI 1548692890 (630) 400-4060
Prime Healthcare Illinois Medical Group LLC
60 mi
Multi-Specialty
2380 E DEMPSTER ST
Des Plaines, IL 60016
  • Reassigned Medicare billing, Illinois enrollment
  • 443 clinicians in this Medicare group
NPI 1023837689 (833) 291-0464

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 8

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 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.
96 services87 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
74 services37 patients
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.
73 services71 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
45 services45 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
45 services45 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
25 services23 patients

Hospital Affiliations CMS Care Compare 2

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

Presence St Marys Hospital

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140155
Location500 W Court StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Riverside Medical Center

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140186
Location350 N Wall StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60914 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.

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 Carolyn Macias's NPI number?

The NPI number for Carolyn Macias is 1548994247. It was assigned to this individual provider in the NPPES registry on July 11, 2022.

Where is Carolyn Macias located?

Carolyn Macias practices at 656 N Convent St Ste C, Bourbonnais, IL 60914. The listed phone number is (815) 936-5167.

What is Carolyn Macias's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carolyn Macias enrolled in Medicare?

Yes. Carolyn Macias 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 Carolyn Macias's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Macias reassigns Medicare benefits to 2 organizations: Midwest Express Care 2, Inc (Willowbrook, IL) and Prime Healthcare Illinois Medical Group LLC (Des Plaines, 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 Carolyn Macias's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carolyn Macias accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Carolyn Macias 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 Carolyn Macias affiliated with any hospitals?

According to CMS data, Carolyn Macias is affiliated with Presence St Marys Hospital and Riverside Medical Center.

When was this NPI record last updated?

The NPPES record for Carolyn Macias was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.