DR. STONEWALL MCCUISTON JR. MD
NPI 1720072143
Pediatrics in Kankakee, IL

Q: What is Stonewall Mccuiston's NPI number?

The NPI number for Stonewall Mccuiston is 1720072143. It was assigned to this individual provider in the NPPES registry on August 31, 2005.

Q: What is Stonewall Mccuiston's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since August 31, 2005PECOS EnrolledAccepts Medicare Assignment

375 N WALL ST STE P310, KANKAKEE, IL 60901(815) 933-0194(815) 936-3847 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 29, 2021, Oct 23, 2019 (2 updates tracked since 2019).

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About Dr. Stonewall Mccuiston Jr. Md NPPES

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

DR. STONEWALL MCCUISTON JR. MD (NPI 1720072143) is an individual pediatrics provider in Kankakee, Illinois, licensed in Illinois (036074737) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Riverside Medical Center, and maintains a secondary practice location in Hopkins Park.

NPPES Registry Identity

NPI1720072143

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. STONEWALL MCCUISTON JR.Credential: MD

Location Address375 N WALL ST STE P310Kankakee, IL 60901-3484

Mailing Address375 N Wall St Ste P310Kankakee, IL 60901-3484 · (815) 933-0194 · Fax (815) 936-3847

Phone(815) 933-0194

Fax(815) 936-3847

Sole ProprietorNo

Medical School CMSMeharry Medical College School Of MedicineGraduated 1985

Enumeration DateAugust 31, 2005

Last NPPES UpdateMarch 29, 20212 updates tracked since enumeration

NPPES CertifiedMarch 29, 2021

✔ NPI 1720072143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in IL · 036074737

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedInternal MedicineTaxonomy 207R00000X · License 036074737 (IL)

375 N WALL ST STE P310, Kankakee, IL 60901

Open in Google Maps ↗

Secondary Practice Location 1

Location 13400 S Main StHopkins Park, IL 60944 · Phone (815) 944-5545 · Fax (815) 944-6723

Other Identifiers 2

Other4623239IL · Blue Cross And Blue Shield Of Illinois

Medicaid036074737IL

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. Stonewall Mccuiston Jr. Md 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 ID9638150014

PECOS Enrollment IDI20040609001388

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 Reassignments

Medicare enrollment records show Stonewall Mccuiston reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Riverside Medical Center

Same address

General Acute Care Hospital

350 N WALL ST
Kankakee, IL 60901

Reassigned Medicare billing, Illinois enrollment
4 clinicians in this Medicare group

NPI 1538208210 (815) 935-7256

Riverside Health System

0.2 mi

Psychiatry

500 N WALL ST, SUITE 200
Kankakee, IL 60901

Reassigned Medicare billing, Illinois enrollment
381 clinicians in this Medicare group

NPI 1336354430 (815) 937-1237

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 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.

89 services38 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

32 services32 patients

Blood glucose (sugar) test performed by hand-held instrument 82962

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

20 services13 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

19 services12 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

17 services17 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Riverside Medical Center

Acute Care Hospitals · Kankakee, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140186

Location350 N Wall StKankakee, IL 60901 · Kankakee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60901 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.

Referred Medical Equipment & Supplies CMS DME claims 7

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

8 suppliers25 claims75 services$6.12 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers14 claims23 services$0.99 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers13 claims39 services$36.16 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers13 claims78 services$2.30 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier11 claims11 services$53.43 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$119.41 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 5

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

MRS. DEANNA J SCHROEDER FNP-BC

Nurse Practitioner (Family)