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MR. ZIYA BAGHMANLI M.D.
NPI 1699068767
Surgery in Red Bud, IL

Active since May 24, 2011PECOS EnrolledAccepts Medicare Assignment
95.01/100
CMS Quality Rating
325 SPRING STREET, RED BUD, IL 62278(618) 282-3831(618) 282-5476 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 29, 2026, Feb 15, 2023, Jun 30, 2021 and 2 more (5 updates tracked since 2017).

About Mr. Ziya Baghmanli M.d. NPPES

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

MR. ZIYA BAGHMANLI M.D. (NPI 1699068767) is an individual surgery provider in Red Bud, Illinois, licensed in Illinois (036.142899) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1699068767
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMR. ZIYA BAGHMANLICredential: M.D.
Location Address325 SPRING STREETRed Bud, IL 62278
Mailing Address911 Forbes DrWaterloo, IL 62298-3173 · (734) 709-3462
Phone(618) 282-3831
Fax(618) 282-5476
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMay 24, 2011
Last NPPES UpdateMay 29, 20265 updates tracked since enumeration
NPPES CertifiedMay 29, 2026
✔ NPI 1699068767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036.142899
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
325 SPRING STREET, Red Bud, IL 62278
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1818 E Broadway StSparta, IL 62286-1820 · Phone (618) 443-1337
Location 2325 Spring StRed Bud, IL 62278-1105 · Phone (419) 383-6462
Location 31300 N Market StSparta, IL 62286-1048 · Phone (618) 443-1337 · Fax (618) 443-1383

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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

Mr. Ziya Baghmanli 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 ID4688978240
PECOS Enrollment IDI20170627001916
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 2

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
14 services14 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
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.

Memorial Hospital

Critical Access Hospitals · Chester, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141338
Location1900 State StChester, IL 62233 · Randolph County
Emergency services

Red Bud Regional Hospital

Critical Access Hospitals · Red Bud, IL
OwnershipProprietary
CMS Certification Number141348
Location325 Spring StreetRed Bud, IL 62278 · Randolph County
Emergency services

Sparta Community Hospital

Critical Access Hospitals · Sparta, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141349
Location818 E BroadwaySparta, IL 62286 · Randolph County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62278 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
$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.

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

Provide Patients Electronic Access to Their Health Information
58%62 patients3/55-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 5

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

MRS. AMBER L HARRIMAN PA
Physician Assistant
325 SPRING STREET
RED BUD, IL 62278
Randolph County (618) 282-3831
RED BUD PHYSICIAN GROUP LLC
Emergency Medicine
325 SPRING STREET
RED BUD, IL 62278
Randolph County (618) 282-3831
MRS. MARY O WUNDERLICH PA
Physician Assistant
325 SPRING STREET
RED BUD, IL 62278
Randolph County (618) 282-3831
MRS. DANIELLE A TURNER APN
Nurse Practitioner
325 SPRING STREET
RED BUD, IL 62278
Randolph County (618) 282-3831
MRS. CHARMAINE E EDWARDS M.D.
Internal Medicine (Gastroenterology)
325 SPRING STREET
RED BUD, IL 62278
Randolph County (618) 282-3831

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 Ziya Baghmanli's NPI number?

The NPI number for Ziya Baghmanli is 1699068767. It was assigned to this individual provider in the NPPES registry on May 24, 2011.

Where is Ziya Baghmanli located?

Ziya Baghmanli practices at 325 Spring Street, Red Bud, IL 62278. The listed phone number is (618) 282-3831.

What is Ziya Baghmanli's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Ziya Baghmanli enrolled in Medicare?

Yes. Ziya Baghmanli 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 Ziya Baghmanli accept?

Health plans from UnitedHealthcare list Ziya Baghmanli 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 Ziya Baghmanli affiliated with any hospitals?

According to CMS data, Ziya Baghmanli is affiliated with Memorial Hospital, Red Bud Regional Hospital and Sparta Community Hospital.

When was this NPI record last updated?

The NPPES record for Ziya Baghmanli was last updated on May 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.