AMY S WASCHULL MD
NPI 1639264625
Family Medicine in Macomb, IL

NPI Status: Active since October 04, 2006

Contact Information

505 E GRANT ST
SUITE 110
MACOMB, IL
ZIP 61455
Phone: (309) 833-1733
Fax: (309) 836-2369

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  • Individual
  • Female
  • Years of Experience 26
  • Family Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About AMY WASCHULL

This page provides the complete NPI Profile along with additional information for Amy Waschull, a primary care provider established in Macomb, Illinois with a medical specialization in Family Medicine and more than 26 years of experience. She graduated from University College Of Medicine in 2001. The healthcare provider is registered in the NPI registry with number 1639264625 assigned on October 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 036112128 (IL). The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI
1639264625
Provider Name
AMY S WASCHULL MD
Other Name
AMY S MARTIN MD
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
505 E GRANT ST SUITE 110 MACOMB, IL 61455
Location Phone
(309) 833-1733
Location Fax
(309) 836-2369
Mailing Address
1025 S 6TH ST SPRINGFIELD, IL 62703
Mailing Phone
(217) 528-7541
Medical School Name
UNIVERSITY COLLEGE OF MEDICINE
Graduation Year
2001
Is Sole Proprietor?
No
Enumeration Date
10-04-2006
Last Update Date
05-19-2020
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A primary care provider (PCP) like Amy Waschull sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
036112128
License State
IL
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
036112128MEDICAID (05)IL 

Medicare Participation & PECOS Enrollment Status

Amy Waschull is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Amy Waschull is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9234194267

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20041201000390

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    7 DME suppliers used 74 Medicare Claims 146 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    6 DME suppliers used 22 Medicare Claims 26 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    4 DME suppliers used 41 Medicare Claims 41 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    3 DME suppliers used 32 Medicare Claims 32 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    3 DME suppliers used 30 Medicare Claims 88 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    3 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    4 DME suppliers used 30 Medicare Claims 30 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    4 DME suppliers used 38 Medicare Claims 193 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    3 DME suppliers used 17 Medicare Claims 17 Services Paid

  • DME-Other DME (DE001N)

    Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

    1 DME suppliers used 41 Medicare Claims 41 Services Paid

  • DME-Other DME (DE000N)

    Nebulizer, with compressor (HCPCS:E0570)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    3 DME suppliers used 62 Medicare Claims 62 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 70 Medicare Claims 70 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 55 Medicare Claims 55 Services Paid

  • DME-Wheelchairs (DD000N)

    Extra heavy duty wheelchair (HCPCS:K0007)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Wheelchairs (DD021N)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    6 DME suppliers used 57 Medicare Claims 57 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

This service was performed 33 times for 30 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 43 times for 34 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 78 times for 70 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 204 times for 127 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 86 times for 86 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

This service was performed 15 times for 15 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 26 times for 13 patients

Injection, methylprednisolone acetate, 80 mg

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

This service was performed 20 times for 16 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 33 times for 33 patients

Nursing facility annual assessment, typically 30 minutes

An annual assessment at a nursing facility is a routine check-up that typically lasts about 30 minutes. It's a chance for healthcare professionals to evaluate your overall health and wellness, monitor any ongoing conditions, and adjust care plans as needed.

This service was performed 11 times for 11 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.42 for a new patient copayment and $24.31 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 61455 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.71
  • Minimum New Patient Price $54.8
  • Maximum New Patient Price $168.44
  • Average New Patient Copayment $21.42
  • Minimum New Patient Copayment $13.7
  • Maximum New Patient Copayment $42.11

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $97.25
  • Minimum Established Patient Price $17.16
  • Maximum Established Patient Price $136.56
  • Average Established Patient Copayment $24.31
  • Minimum Established Patient Copayment $4.29
  • Maximum Established Patient Copayment $34.14

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Amy Waschull is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SAINT FRANCIS MEDICAL CENTER530 NE GLEN OAK AVE
PEORIA, IL 61637
(309) 655-2000Acute Care Hospitals
MC DONOUGH DISTRICT HOSPITAL525 EAST GRANT STREET
MACOMB, IL 61455
(309) 833-4101Acute Care Hospitals
MEMORIAL HOSPITAL1454 N COUNTY ROAD 2050 E
CARTHAGE, IL 62321
(217) 357-8500Critical Access Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1639264625, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
3
Doubled → 6
Pos 4
9
Unchanged
Pos 5
2
Doubled → 4
Pos 6
6
Unchanged
Pos 7
4
Doubled → 8
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 2 → 4 4 → 8 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 6 + 9 + 4 + 6 + 8 + 6 + 4 + 24 = 75

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1639264625.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ophthalmology
505 E GRANT ST, STE 206
MACOMB, IL 61455
Advanced Practice Midwife
505 E GRANT ST
MACOMB, IL 61455
Nurse Practitioner (Women's Health)
505 E GRANT ST
MACOMB, IL 61455
Internal Medicine
505 E GRANT ST, STE 103
MACOMB, IL 61455
Pediatrics
505 E GRANT ST, SUITE 103
MACOMB, IL 61455
Family Medicine
505 E GRANT ST, SUITE 110
MACOMB, IL 61455
Family Medicine
505 E GRANT ST
MACOMB, IL 61455
Pediatrics
505 E GRANT ST, SUITE 201
MACOMB, IL 61455
Orthopaedic Surgery
505 E GRANT ST, SUITE 205
MACOMB, IL 61455
Optometrist
505 E GRANT ST, SUITE 206
MACOMB, IL 61455
Ophthalmology
505 E GRANT ST, SUITE 206
MACOMB, IL 61455
Obstetrics & Gynecology
505 E GRANT ST, SUITE 102
MACOMB, IL 61455
General Acute Care Hospital
505 E GRANT ST, SUITE 306
MACOMB, IL 61455
Family Medicine
505 E GRANT ST, SUITE 202
MACOMB, IL 61455
Pediatrics
505 E GRANT ST, SUITE 202
MACOMB, IL 61455
Nurse Practitioner
505 E GRANT ST
MACOMB, IL 61455
Internal Medicine
505 E GRANT ST, SUTIE 202
MACOMB, IL 61455
Clinical Medical Laboratory
505 E GRANT ST
MACOMB, IL 61455
Counselor (Addiction (Substance Use Disorder))
505 E GRANT ST
MACOMB, IL 61455
Family Medicine
505 E GRANT ST, FAMILY PRACTICE ASSOCIATES OF MACOMB LTD
MACOMB, IL 61455

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639264625, enumerated as an "individual" on October 04, 2006.

The provider is located at 505 E GRANT ST SUITE 110 MACOMB, IL 61455 and the phone number is (309) 833-1733.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Amy Waschull is affiliated with: SAINT FRANCIS MEDICAL CENTER, MC DONOUGH DISTRICT HOSPITAL and MEMORIAL HOSPITAL.