ANDREW POULOS MD
NPI 1760801120
Family Medicine in Effingham, IL

Q: What is Andrew Poulos's NPI number?

The NPI number for Andrew Poulos is 1760801120. It was assigned to this individual provider in the NPPES registry on April 15, 2014.

Q: What is Andrew Poulos's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Andrew Poulos was last updated on September 28, 2022. 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.

Active since April 15, 2014PECOS EnrolledAccepts Medicare Assignment

900 W TEMPLE AVE STE 1500, EFFINGHAM, IL 62401(217) 347-0458(217) 342-2992 Get Directions Write a Review

NPPES record last updated: September 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 28, 2022, Aug 30, 2017 (2 updates tracked since 2017).

On this page

About Andrew Poulos Md NPPES

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

ANDREW POULOS MD (NPI 1760801120) is an individual family medicine provider in Effingham, Illinois, licensed in Illinois (036161439) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and maintains a secondary practice location in Eau Claire.

NPPES Registry Identity

NPI1760801120

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameANDREW POULOSCredential: MD

Location Address900 W TEMPLE AVE STE 1500Effingham, IL 62401-2121

Mailing Address900 W Temple Ave Ste 1500Effingham, IL 62401-2121 · (217) 347-0458 · Fax (217) 342-2992

Phone(217) 347-0458

Fax(217) 342-2992

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateApril 15, 2014

Last NPPES UpdateSeptember 28, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 28, 2022

✔ NPI 1760801120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in IL · 036161439✔ Licensed in MI · 4301113522

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.

900 W TEMPLE AVE STE 1500, Effingham, IL 62401

Open in Google Maps ↗

Secondary Practice Location 1

Location 1617 W Clairemont AveEau Claire, WI 54701-6223 · Phone (715) 839-5175 · Fax (715) 839-5176

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.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

Andrew Poulos 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 ID7214244037

PECOS Enrollment IDI20170912000318, I20220830003498

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

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.

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.

89 services46 patients

Hospital Affiliations CMS Care Compare 2

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

St Anthonys Memorial Hospital

Acute Care Hospitals · Effingham, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140032

Location503 N Maple StreetEffingham, IL 62401 · Effingham County

Emergency services Birthing friendly

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62401 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 12

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

11 suppliers46 claims114 services$5.91 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers16 claims20 services$1.03 avg. paid by Medicare

Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185

Other-Enteral and Parenteral · category OB005N

1 supplier45 claims346 services$11.28 avg. paid by Medicare

Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix B4189

Other-Enteral and Parenteral · category OB005N

1 supplier45 claims316 services$178.50 avg. paid by Medicare

Parenteral nutrition supply kit; premix, per day B4220

Other-Enteral and Parenteral · category OB005N

1 supplier35 claims246 services$8.04 avg. paid by Medicare

Parenteral nutrition administration kit, per day B4224

Other-Enteral and Parenteral · category OB005N

1 supplier44 claims309 services$24.88 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.

STEPHANIE D JACKSON APRN

Nurse Practitioner (Family)