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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. PAYTON K. MCGOWEN M.D.
NPI 1629381256
Hospitalist in Belleville, IL

Active since July 25, 2010PECOS EnrolledAccepts Medicare Assignment
90.77/100
CMS Quality Rating
4550 MEMORIAL DR, STE. 340, BELLEVILLE, IL 62226(618) 257-6200(618) 257-6679 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Payton K. Mcgowen M.d. NPPES

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

DR. PAYTON K. MCGOWEN M.D. (NPI 1629381256) is an individual hospitalist provider in Belleville, Illinois, licensed in Illinois (036132150) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS, is affiliated with Hshs Holy Family Hospital Inc, and is a graduate of University Of Missouri, Kansas City, School Of Medicine (2010).

NPPES Registry Identity

NPI1629381256
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameDR. PAYTON K. MCGOWENCredential: M.D.
Location Address4550 MEMORIAL DR, STE. 340Belleville, IL 62226-5372
Mailing Address4550 Memorial Dr, Ste. 340Belleville, IL 62226-5372 · (618) 257-6200 · Fax (618) 257-6679
Phone(618) 257-6200
Fax(618) 257-6679
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 2010
Enumeration DateJuly 25, 2010
Last NPPES UpdateAugust 25, 2026
NPPES CertifiedAugust 25, 2026
✔ NPI 1629381256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in IL · 036132150
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 2015034882 (MO), 036132150 (IL)
4550 MEMORIAL DR, Belleville, IL 62226
Open in Google Maps ↗

Other Identifiers 1

Other036132150IL · Idfpr

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. Payton K. Mcgowen 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 ID5597905935
PECOS Enrollment IDI20130709000381
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

3

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

Cep America - Illinois Snf, LLP
Same address
Infectious Disease
4500 MEMORIAL DR
Belleville, IL 62226
  • Reassigned Medicare billing, Illinois enrollment
  • 51 clinicians in this Medicare group
NPI 1003328329 (618) 233-7750
Cep America-Illinois Hospitalists, LLP
Same address
Internal Medicine
4500 MEMORIAL DR
Belleville, IL 62226
  • Reassigned Medicare billing, Illinois enrollment
  • 329 clinicians in this Medicare group
NPI 1841613403 (618) 233-7750
Galen Inpatient Physicians PC.
25 mi
Hospitalist
1015 BOWLES AVE
Fenton, MO 63026
  • Reassigned Medicare billing, Missouri and California enrollments
  • Also billed through NPI 1316037021 (California)
  • 93 clinicians in this Medicare group
NPI 1538714688 (636) 496-2000

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 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 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.
235 services137 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
93 services92 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.
48 services48 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.
30 services24 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
20 services19 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
15 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Hshs Holy Family Hospital Inc

Acute Care Hospitals · Greenville, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140137
Location200 Health Care DrGreenville, IL 62246 · Bond County
Emergency services

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

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

St Joseph's Hospital

Critical Access Hospitals · Highland, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number141336
Location12866 Troxler AvenueHighland, IL 62249 · Madison County
Emergency services

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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
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.

90.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.98
Improvement Activities40
Cost68.13

Other Providers at the Same Location NPPES 20

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

MRS. DEANNA L. RODENBERG NP
Nurse Practitioner
4550 MEMORIAL DR, STE. 340
BELLEVILLE, IL 62226
St. Clair County (618) 257-6200
SHEIKH M SADIQ MD
Psychiatry & Neurology (Neurology)
4550 MEMORIAL DR, SUITE 340
BELLEVILLE, IL 62226
St. Clair County (618) 257-4243
DR. DWIGHT WILLIAM O'DELL M.D.
Obstetrics & Gynecology (Gynecology)
4550 MEMORIAL DR, STE 200
BELLEVILLE, IL 62226
St. Clair County (618) 233-5998
MEMORIAL MEDICAL GROUP, LLC
Internal Medicine
4550 MEMORIAL DR, STE. 340
BELLEVILLE, IL 62226
St. Clair County (618) 257-6302
BELLEVILLE ORTHOPEDICS, P.C.
Specialist
4550 MEMORIAL DR, SUITE 460
BELLEVILLE, IL 62226
St. Clair County (618) 235-2900
MSA ALLIANCE, LLC
Urology
4550 MEMORIAL DR, STE 350
BELLEVILLE, IL 62226
St. Clair County (618) 239-9690
LAKSHMI R. BEERAVOLU MD
Psychiatry & Neurology (Clinical Neurophysiology)
4550 MEMORIAL DR, STE. A480
BELLEVILLE, IL 62226
St. Clair County (618) 234-4531
CA GROUP, LLC
Internal Medicine (Cardiovascular Disease)
4550 MEMORIAL DR, STE 310
BELLEVILLE, IL 62226
St. Clair County (618) 257-6112

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 Payton Mcgowen's NPI number?

The NPI number for Payton Mcgowen is 1629381256. It was assigned to this individual provider in the NPPES registry on July 25, 2010.

Where is Payton Mcgowen located?

Payton Mcgowen practices at 4550 Memorial Dr Ste. 340, Belleville, IL 62226. The listed phone number is (618) 257-6200.

What is Payton Mcgowen's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Payton Mcgowen enrolled in Medicare?

Yes. Payton Mcgowen 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 Payton Mcgowen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Payton Mcgowen reassigns Medicare benefits to 3 organizations: Cep America - Illinois Snf, LLP (Belleville, IL), Cep America-Illinois Hospitalists, LLP (Belleville, IL) and Galen Inpatient Physicians PC. (Fenton, MO). 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 Payton Mcgowen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Payton Mcgowen affiliated with any hospitals?

According to CMS data, Payton Mcgowen is affiliated with Hshs Holy Family Hospital Inc, St Josephs Hospital, Hshs St Elizabeth's Hospital and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Payton Mcgowen was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 57 days 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.