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DR. ARISTIDES J. GARCES M.D.
NPI 1679672273
Family Medicine in O Fallon, IL

Active since September 21, 2006PECOS EnrolledAccepts Medicare Assignment
95.01/100
CMS Quality Rating
3 SAINT ELIZABETH BLVD STE 4000, O FALLON, IL 62269(618) 233-5480(618) 222-4792 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 4, 2021, Apr 22, 2019 (2 updates tracked since 2019).

About Dr. Aristides J. Garces M.d. NPPES

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

DR. ARISTIDES J. GARCES M.D. (NPI 1679672273) is an individual family medicine provider in O Fallon, Illinois, licensed in Illinois (036069091) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1983).

NPPES Registry Identity

NPI1679672273
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. ARISTIDES J. GARCESCredential: M.D.
Location Address3 SAINT ELIZABETH BLVD STE 4000O Fallon, IL 62269-1284
Mailing Address3 Saint Elizabeth Blvd Ste 4000O Fallon, IL 62269-1284 · (618) 233-5480 · Fax (618) 222-4792
Phone(618) 233-5480
Fax(618) 222-4792
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1983
Enumeration DateSeptember 21, 2006
Last NPPES UpdateSeptember 12, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 12, 2023
✔ NPI 1679672273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036069091
Definition
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.
3 SAINT ELIZABETH BLVD STE 4000, O Fallon, IL 62269
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Other Identifiers 1

Medicaid036069091IL

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

Dr. Aristides J. Garces 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 ID4284822099
PECOS Enrollment IDI20101221000650
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 Reassignment

Medicare enrollment records show Aristides Garces reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern Illinois Healthcare Foundation Inc
Same address
Federally Qualified Health Center (FQHC)
3 SAINT ELIZABETH BLVD STE 4000
O Fallon, IL 62269
  • Reassigned Medicare billing, Illinois enrollment
  • 164 clinicians in this Medicare group
NPI 1225556996 (618) 233-5480

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62269 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
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.

95.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.02
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%383 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
43%745 patients2/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
6%697 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
56%1,512 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
27%405 patients2/55-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%7,235 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%8,759 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
22%817 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%889 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.
81%4,241 patients4/55-star benchmark: 97%
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%4,241 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
21%4,241 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
26%4,241 patients
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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers29 claims65 services$5.24 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$106.94 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
2 suppliers11 claims510 services$5.07 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
2 suppliers11 claims510 services$0.84 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
4 suppliers20 claims20 services$23.51 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MARA GRACE DOWNING MD
Student in an Organized Health Care Education/Training Program
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 233-5480
DR. NOAH M COOPERSTEIN MD
Family Medicine
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 256-7311
DR. PATRICK BLOECHER MD
Family Medicine
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 233-7880
BENJAMIN F WOOD MD
Student in an Organized Health Care Education/Training Program
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 233-5480
SALSAPELA HIYTHAM SHABAN MD
Student in an Organized Health Care Education/Training Program
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 233-5480
MARIA OCHIAI
Military Health Care Provider
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 256-9355
LUKE BRECHNER
Military Health Care Provider
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 256-9355
ALEX BRANDON BELONGY
General Practice
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
St. Clair County (618) 256-9355

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 Aristides Garces's NPI number?

The NPI number for Aristides Garces is 1679672273. It was assigned to this individual provider in the NPPES registry on September 21, 2006.

Where is Aristides Garces located?

Aristides Garces practices at 3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL 62269. The listed phone number is (618) 233-5480.

What is Aristides Garces's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Aristides Garces enrolled in Medicare?

Yes. Aristides Garces 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 organization bills Medicare for Aristides Garces's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Aristides Garces reassigns Medicare benefits to Southern Illinois Healthcare Foundation Inc (O Fallon, IL). The 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 Aristides Garces's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Aristides Garces accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Aristides Garces 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.

When was this NPI record last updated?

The NPPES record for Aristides Garces was last updated on September 12, 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.