DR. MACK E MCCAIN M.D.
NPI 1558321190
Internal Medicine - Gastroenterology in Herrin, IL

Q: What is Mack Mccain's NPI number?

The NPI number for Mack Mccain is 1558321190. It was assigned to this individual provider in the NPPES registry on March 27, 2006.

Q: What is Mack Mccain's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Mack Mccain was last updated on September 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since March 27, 2006PECOS EnrolledAccepts Medicare Assignment

75.73/100

CMS Quality Rating

404 LINCOLN DR, HERRIN, IL 62948(618) 993-0056(618) 993-0752 Get Directions Write a Review

NPPES record last updated: September 27, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 27, 2021, Jan 29, 2021, May 14, 2019 and 1 more (4 updates tracked since 2018).

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About Dr. Mack E Mccain M.d. NPPES

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

DR. MACK E MCCAIN M.D. (NPI 1558321190) is an individual gastroenterology provider in Herrin, Illinois, licensed in Illinois (36079027) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Carle Foundation Hospital, and maintains a secondary practice location in Carbondale.

NPPES Registry Identity

NPI1558321190

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. MACK E MCCAINCredential: M.D.

Location Address404 LINCOLN DRHerrin, IL 62948

Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 457-5200

Phone(618) 993-0056

Fax(618) 993-0752

Sole ProprietorYes

Medical School CMSHoward University College Of MedicineGraduated 1981

Enumeration DateMarch 27, 2006

Last NPPES UpdateSeptember 27, 20214 updates tracked since enumeration

NPPES CertifiedSeptember 27, 2021

✔ NPI 1558321190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in IL · 36079027

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

404 LINCOLN DR, Herrin, IL 62948

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Secondary Practice Location 1

Location 12601 W Main StCarbondale, IL 62901-1031 · Phone (618) 351-7300 · Fax (618) 457-7890

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. Mack E Mccain M.d. 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 ID4284667379

PECOS Enrollment IDI20090828000494

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

Medicare enrollment records show Mack Mccain reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Deaconess Illinois Specialty Clinic, Inc.

1.7 mi

Orthopaedic Surgery

3329 W DEYOUNG ST
Marion, IL 62959

Reassigned Medicare billing, Illinois enrollment
228 clinicians in this Medicare group

NPI 1386351856 (618) 998-7177

Southern Illinois Medical Services, Nfp

9.2 mi

Internal Medicine

1239 E MAIN ST
Carbondale, IL 62901

Reassigned Medicare billing, Illinois enrollment
702 clinicians in this Medicare group

NPI 1770656837 (618) 457-5200

Carle Health Medical Group

169 mi

Internal Medicine

611 W PARK ST
Urbana, IL 61801

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Carle Health Care Incorporated
2,516 clinicians in this Medicare group

NPI 1154653947 (217) 383-8300

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 14

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

155 services146 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.

81 services61 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

73 services73 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

71 services69 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.

40 services40 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

34 services34 patients

Dilation of esophagus 43450

Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.

31 services28 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.

30 services26 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

28 services27 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

19 services18 patients

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.

18 services17 patients

Imaging of digestive tract done from the inside of the digestive tract 91110

This procedure, known as an endoscopy, involves a small camera being passed into the digestive tract. It helps doctors to see the inside of your digestive system in detail. This can aid in diagnosing conditions or planning treatments. It's generally safe and can provide valuable information.

17 services12 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

16 services16 patients

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500

Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Carle Foundation Hospital

Acute Care Hospitals · Urbana, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140091

Location611 West Park StreetUrbana, IL 61801 · Champaign County

Emergency services Birthing friendly

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number140184

Location3333 W DeyoungMarion, IL 62959 · Williamson County

Emergency services

Crossroads Community Hospital

Acute Care Hospitals · Mount Vernon, IL

OwnershipProprietary

CMS Certification Number140294

Location8 Doctors Park RdMount Vernon, IL 62864 · Jefferson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62948 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

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.

75.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.09

Promoting Interoperability

100

Improvement Activities

Cost

45.26

Other Providers at the Same Location NPPES 5

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

AMY LEEANN MILLER APRN

Nurse Practitioner