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WHITNEY DONALDSON
NPI 1700412046
Nurse Practitioner - Family in Decatur, IL

Active since March 18, 2020PECOS EnrolledAccepts Medicare Assignment
67.18/100
CMS Quality Rating
304 W HAY ST STE 213, DECATUR, IL 62526(217) 876-6640 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 1, 2020, Mar 18, 2020 (2 updates tracked since 2020).

About Whitney Donaldson NPPES

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

WHITNEY DONALDSON (NPI 1700412046) is an individual family provider in Decatur, Illinois, licensed in Illinois (209.021044) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Decatur Memorial Hospital, and maintains a secondary practice location in Decatur.

NPPES Registry Identity

NPI1700412046
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameWHITNEY DONALDSON
Location Address304 W HAY ST STE 213Decatur, IL 62526-4169
Mailing Address2120 N 27th StDecatur, IL 62526-2191
Phone(217) 876-6640
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 18, 2020
Last NPPES UpdateSeptember 1, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2020
✔ NPI 1700412046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.021044
304 W HAY ST STE 213, Decatur, IL 62526
Open in Google Maps ↗

Secondary Practice Location 1

Location 12120 N 27th StDecatur, IL 62526-2191 · Phone (217) 663-6901

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

Whitney Donaldson 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 ID4486070091
PECOS Enrollment IDI20200813000993
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 6

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.

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.
684 services249 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.
102 services79 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.
79 services64 patients
Injection of trigger points, 3 or more muscles 20553
Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.
41 services26 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
37 services22 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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
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.

67.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.86
Improvement Activities40
Cost56.87

Other Providers at the Same Location NPPES 3

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

SYDNEY GROHLER FNP-C
Nurse Practitioner (Family)
304 W HAY ST STE 213
DECATUR, IL 62526
Macon County (217) 876-6640
FRANCESCO VETRI M.D. PH.D.
Anesthesiology (Pain Medicine)
304 W HAY ST STE 213
DECATUR, IL 62526
Macon County (217) 876-6640
DR. SUNDARARAJ R CHERALA MD
Pain Medicine (Interventional Pain Medicine)
304 W HAY ST STE 213
DECATUR, IL 62526
Macon County (217) 876-6640

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 Whitney Donaldson's NPI number?

The NPI number for Whitney Donaldson is 1700412046. It was assigned to this individual provider in the NPPES registry on March 18, 2020.

Where is Whitney Donaldson located?

Whitney Donaldson practices at 304 W Hay St Ste 213, Decatur, IL 62526. The listed phone number is (217) 876-6640.

What is Whitney Donaldson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Whitney Donaldson enrolled in Medicare?

Yes. Whitney Donaldson 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.

Is Whitney Donaldson affiliated with any hospitals?

According to CMS data, Whitney Donaldson is affiliated with Decatur Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Whitney Donaldson was last updated on September 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.