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DR. JOHN DOUGLAS SADOFF M.D.
NPI 1619973765
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Swansea, IL

Active since June 23, 2005PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
9 PARK PL, SWANSEA, IL 62226(618) 233-5722(618) 233-7069 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2023, Jul 22, 2022 (2 updates tracked since 2022).

About Dr. John Douglas Sadoff M.d. NPPES

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

DR. JOHN DOUGLAS SADOFF M.D. (NPI 1619973765) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Swansea, Illinois, licensed in Illinois (036110178) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1619973765
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameDR. JOHN DOUGLAS SADOFFCredential: M.D.
Location Address9 PARK PLSwansea, IL 62226-2967
Mailing Address9 Park Pl, Ste BSwansea, IL 62226-2967 · (618) 233-5722 · Fax (618) 233-7069
Phone(618) 233-5722
Fax(618) 233-7069
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJune 23, 2005
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedJuly 22, 2022
✔ NPI 1619973765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in IL · 036110178
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
9 PARK PL, Swansea, IL 62226
Open in Google Maps ↗

Other Identifiers 5

Other011619579MO · Bndd
Medicaid036110178IL
Other036071034IL · Substance Control
Other2003022258MO · License
Other036110178IL · License

Accepted Insurance

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

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

Dr. John Douglas Sadoff 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 ID1456252907
PECOS Enrollment IDI20040301000184
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 10

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 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.
64 services54 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.
35 services34 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
23 services23 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
23 services23 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.
22 services22 patients
Ultrasonic guidance during surgery 76998
Ultrasonic guidance during surgery is a technique that uses sound waves to create real-time images of the inside of your body. This helps the surgeon navigate and perform procedures more accurately, reducing the risk of complications. It's like a GPS for your body's internal structures.
21 services21 patients

Hospital Affiliations CMS Care Compare 3

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

St Josephs Hospital

Acute Care Hospitals · Breese, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140145
Location9515 Holy Cross LnBreese, IL 62230 · Clinton County
Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62226 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
$173.35 typical visit price
range $56.28 – $173.35
Typical copayment $43.33 (range $14.07 – $43.33)
Most-billed visit code 99205
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
Most-billed visit code 99213
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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
88%51 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%629 patients5/55-star benchmark: 100%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
88%32 patients4/55-star benchmark: 100%
Patient-Specific Education
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.
68%120 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
38%252 patients2/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
42%24 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
56%64 patients3/55-star benchmark: 100%
Provide Patient Access
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…
100%120 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

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

MR. KENNETH CLEMENTS RNFA
Registered Nurse (Registered Nurse First Assistant)
9 PARK PL
SWANSEA, IL 62226
St. Clair County (618) 233-5722
DR. BILL BATES DAILY JR. M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
9 PARK PL
SWANSEA, IL 62226
St. Clair County (618) 233-5722
MR. DAVID COOPER RNFA
Registered Nurse (Registered Nurse First Assistant)
9 PARK PL
SWANSEA, IL 62226
St. Clair County (618) 233-5722
MR. KEITH HURST RNFA
Registered Nurse (Registered Nurse First Assistant)
9 PARK PL
SWANSEA, IL 62226
St. Clair County (618) 233-5722

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 Sadoff's NPI number?

The NPI number for John Sadoff is 1619973765. It was assigned to this individual provider in the NPPES registry on June 23, 2005.

Where is John Sadoff located?

John Sadoff practices at 9 Park Pl, Swansea, IL 62226. The listed phone number is (618) 233-5722.

What is John Sadoff's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is John Sadoff enrolled in Medicare?

Yes. John Sadoff 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.

What insurance does John Sadoff accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list John Sadoff 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 Sadoff affiliated with any hospitals?

According to CMS data, John Sadoff is affiliated with St Josephs Hospital, Memorial Hospital and Hshs St Elizabeth's Hospital.

When was this NPI record last updated?

The NPPES record for John Sadoff was last updated on March 7, 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.