EVELENA ONTIVEROS MD PHD
NPI 1689886962
Internal Medicine - Hematology & Oncology in Decatur, IL

Q: What is Evelena Ontiveros's NPI number?

The NPI number for Evelena Ontiveros is 1689886962. It was assigned to this individual provider in the NPPES registry on May 7, 2007.

Q: What is Evelena Ontiveros's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Evelena Ontiveros was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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 May 07, 2007PECOS EnrolledAccepts Medicare Assignment

77.67/100

CMS Quality Rating

210 W MCKINLEY AVE STE 1, DECATUR, IL 62526(217) 876-6600(217) 876-6606 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 12, 2025, Nov 6, 2025, May 8, 2017 (3 updates tracked since 2017).

On this page

About Evelena Ontiveros Md Phd NPPES

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

EVELENA ONTIVEROS MD PHD (NPI 1689886962) is an individual hematology & oncology provider in Decatur, Illinois, licensed in Illinois (036143984) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Decatur Memorial Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1689886962

Entity TypeIndividualFemale

Primary Taxonomy207RH0003X

Provider Legal NameEVELENA ONTIVEROSCredential: MD PHD

Location Address210 W MCKINLEY AVE STE 1Decatur, IL 62526-5858

Mailing Address210 W Mckinley Ave Ste 1Decatur, IL 62526-5858 · (217) 329-3232 · Fax (217) 329-1670

Phone(217) 876-6600

Fax(217) 876-6606

Sole ProprietorNo

Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 2004

Enumeration DateMay 7, 2007

Last NPPES UpdateNovember 12, 20253 updates tracked since enumeration

NPPES CertifiedNovember 12, 2025

✔ NPI 1689886962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in IL · 036143984

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

210 W MCKINLEY AVE STE 1, Decatur, IL 62526

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Secondary Practice Locations 2

Location 1101 E 9th St Ste 1Pana, IL 62557-1716 · Phone (217) 876-6600 · Fax (217) 876-6606

Location 21990 E Lake Shore DrDecatur, IL 62521-3811 · Phone (217) 876-6600 · Fax (217) 876-6606

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

Evelena Ontiveros Md Phd 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 ID345490058

PECOS Enrollment IDI20170807001909

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 Evelena Ontiveros reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cancer Care Specialists Of Central Illinois, S.C.

Same address

Medical Oncology

210 W MCKINLEY AVE, SUITE 1
Decatur, IL 62526

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Cancer Care Specialists Of Central Illinois Sc
36 clinicians in this Medicare group

NPI 1871580142 (217) 876-6600

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 72

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.

Injection, ferric carboxymaltose, 1 mg J1439

Ferric carboxymaltose is an iron supplement injection. It's given when your body needs more iron than you can consume through diet, like in anemia. The injection is administered by a healthcare professional into a vein.

71,930 services37 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

14,000 services93 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

3,300 services12 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

1,795 services31 patients

Injection, ondansetron hydrochloride, per 1 mg J2405

Ondansetron hydrochloride is a medication given via injection to help prevent nausea and vomiting, often due to chemotherapy or surgery. It works by blocking certain chemicals in the body that trigger these symptoms.

1,560 services24 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.

1,411 services482 patients

Insertion of needle into vein for collection of blood sample 36415

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.

1,155 services354 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

883 services255 patients

Injection of additional new drug or substance into vein 96375

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

774 services51 patients

Microscopic examination for white blood cells with manual cell count 85007

This is a lab test where a small sample of your blood is studied under a microscope. The goal is to count the number of white blood cells, which are crucial for your body's immune response. The count can help identify potential health issues.

767 services216 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

767 services216 patients

Injection, palonosetron hcl, 25 mcg J2469

Palonosetron HCL is an injection used to prevent nausea and vomiting caused by chemotherapy. It works by blocking a natural substance (serotonin) in the body that can cause vomiting. This helps improve your comfort during cancer treatment.

700 services18 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

528 services250 patients

Iron level 83540

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

410 services231 patients

Iron binding capacity 83550

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

410 services231 patients

Ferritin (blood protein) level 82728

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

388 services224 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

282 services48 patients

Gammaglobulin (immune system protein) measurement 82784

Gammaglobulin measurement is a blood test that checks the levels of certain proteins (gammaglobulins) that the body uses to fight infections. High or low levels can indicate various health conditions. It's a simple, quick procedure with minimal discomfort.

240 services37 patients

Injection of drug or substance under skin or into muscle 96372

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.

239 services46 patients

Injection, diphenhydramine hcl, up to 50 mg J1200

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

227 services40 patients

Magnesium level 83735

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

216 services66 patients

Injection of drug or substance into vein 96374

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

207 services57 patients

Measurement of immunoglobulin light chains 83521

Measurement of immunoglobulin light chains is a blood test that helps to detect and monitor certain disorders related to your immune system. It measures the levels of specific proteins, known as light chains, produced by your immune cells.

158 services35 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

152 services80 patients

Lactate dehydrogenase (enzyme) level 83615

A Lactate Dehydrogenase level test measures the amount of this enzyme in your body. It's often done when tissue damage is suspected, as high levels can indicate issues like heart disease, lung disease, liver disease, or blood disorders. This test helps in diagnosing and monitoring these conditions.

150 services76 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

126 services70 patients

Infusion into a vein for hydration, each additional hour 96361

This procedure involves delivering fluids directly into your vein to keep your body hydrated. It is typically done when oral hydration is insufficient. Each additional hour means more fluid is infused to ensure adequate hydration.

125 services13 patients

Collection of blood sample from implanted device 36591

Collection of a blood sample from an implanted device involves drawing blood from a device placed under your skin. This device, often a port or catheter, allows easy access to your bloodstream. The procedure is usually quick and causes minimal discomfort.

118 services31 patients

Irrigation of implanted venous access drug delivery device 96523

Irrigation of an implanted venous access drug delivery device is a procedure to clean or unblock the device. This device is implanted under your skin to allow easy, frequent, and long-term access to your veins for medication delivery. The process involves flushing the device with a sterile solution to ensure it works properly.

115 services30 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

112 services46 patients

Red blood cell concentration measurement 85014

Red blood cell concentration measurement is a routine blood test that assesses the number of red blood cells in your blood. These cells carry oxygen throughout your body. The test can help identify conditions like anemia or dehydration. It's a simple, quick, and relatively painless procedure.

112 services51 patients

Blood count, hemoglobin 85018

A blood count, specifically hemoglobin, is a standard test that measures the amount of hemoglobin in your blood. Hemoglobin is a protein in red blood cells that carries oxygen throughout your body. This test helps assess your overall health and detect a variety of disorders such as anemia or polycythemia.

112 services51 patients

Injection, zoledronic acid, 1 mg J3489

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

104 services15 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.

98 services98 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

89 services56 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

80 services49 patients

Administration of additional new drug or substance into vein, 1 hour or less 96417

This procedure involves introducing a new drug or substance into your vein, typically via an IV drip. It lasts for an hour or less. This method allows the substance to quickly reach your bloodstream, ensuring rapid and effective treatment.

79 services19 patients

Cyanocobalamin (vitamin b-12) level 82607

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

69 services53 patients

Infusion into a vein for hydration, 31-60 minutes 96360

This is a procedure where a sterile solution is administered into your vein to help restore body fluid balance. It typically lasts between 31-60 minutes. It's a safe, common treatment for dehydration or to deliver medication.

69 services19 patients

Carcinoembryonic antigen (cea) protein level 82378

Carcinoembryonic Antigen (CEA) protein level is a blood test often used in cancer care. It measures the amount of CEA protein in your blood, which can increase in cases of certain types of cancer. It's used to monitor treatment progress and check for cancer recurrence.

68 services47 patients

Uric acid level, blood 84550

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

62 services25 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less 96367

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

59 services11 patients

Red blood count, automated test 85045

An automated red blood count test is a routine lab procedure to measure the number of red blood cells in your blood. These cells carry oxygen throughout the body. The test helps assess overall health and detect conditions like anemia or polycythemia.

56 services44 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

56 services31 patients

Infusion, normal saline solution , 1000 cc J7030

An infusion of normal saline solution, 1000 cc, is a common medical procedure. It involves introducing a saltwater solution into your bloodstream via an intravenous (IV) line. This helps to hydrate your body, correct electrolyte imbalances, and deliver medications if needed.

55 services14 patients

Administration of chemotherapy into vein, each additional hour 96415

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

53 services12 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.

51 services44 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

47 services11 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

45 services11 patients

Folic acid level, serum 82746

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

43 services32 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

42 services28 patients

Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month 99426

Principal care management services focus on managing a single high-risk disease. This involves a health care professional directing clinical staff for the first 30 minutes each month. The aim is to monitor your health, coordinate care, and provide necessary support for your disease management.

40 services24 patients

Immunologic analysis for detection of tumor antigen, quantitative; ca 15-3 86300

This is a blood test that measures the level of CA 15-3, a protein often higher in individuals with certain types of cancer. It helps monitor response to treatment and check for cancer recurrence. It's not a standalone diagnostic test but used alongside other evaluations.

38 services23 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.

37 services34 patients

Nuclear medicine study from skull base to mid-thigh with ct scan 78815

A nuclear medicine study from skull base to mid-thigh with a CT scan involves using a small amount of radioactive material and CT imaging to examine body tissues and organs. This helps detect any abnormalities by providing detailed images of the body's internal structure.

36 services33 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

36 services25 patients

Beta-2 microglobulin (protein) level 82232

The Beta-2 microglobulin level test measures the amount of this protein in your blood. It's often used to check kidney function or monitor certain cancers. High levels may indicate a health issue. The test involves a simple blood draw.

33 services19 patients

Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries A9552

Fluorodeoxyglucose F-18 FDG is a radioactive drug used in PET scans. It helps doctors see how your tissues and organs are functioning. The drug is given in a specific dose, up to 45 millicuries, depending on your body size and the type of scan.

33 services31 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

32 services30 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

32 services27 patients

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.

32 services20 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

29 services17 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

27 services25 patients

Phosphate level 84100

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

25 services22 patients

Kidney function blood test panel 80069

A kidney function blood test panel checks how well your kidneys are working. It measures levels of various substances in your blood, including proteins, electrolytes, and waste products. The results can help detect potential kidney issues early.

22 services13 patients

Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by health care professional, per calendar month 99427

Principal Care Management (PCM) services focus on managing a single high-risk disease. It involves additional 30 minutes of clinical staff time per month, overseen by a healthcare professional. This includes monitoring your health, coordinating care, and developing a personalized treatment plan.

20 services11 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

17 services17 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

16 services15 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

14 services13 patients

Urea nitrogen level to assess kidney function, quantitative 84520

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

14 services13 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

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.

12 services11 patients

Erythropoietin (protein) level 82668

Erythropoietin level is a blood test that measures the amount of erythropoietin (a protein) in your body. This protein helps in the production of red blood cells. The test aids in diagnosing conditions related to red blood cells, like anemia or polycythemia.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140135

Location2300 North Edward StreetDecatur, IL 62526 · Macon County

Emergency services Birthing friendly

St Marys Hospital

Acute Care Hospitals · Decatur, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140166

Location1800 E Lake Shore DrDecatur, IL 62521 · Macon County

Emergency services Birthing friendly

Pana Community Hospital

Critical Access Hospitals · Pana, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141341

Location101 E Ninth StreetPana, IL 62557 · Christian County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 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

$168.44 typical visit price

range $54.80 – $168.44

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

Most-billed visit code 99205

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.

77.67/100

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

Scored as part of a group practice

Quality

73.39

Promoting Interoperability

Improvement Activities

Cost

52.7

Other Providers at the Same Location NPPES 7

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

THOMAS H TARTER M.D.

Surgery (Surgical Oncology)