DANE JACK CHURCH MD
NPI 1790128387
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Springfield, IL

Q: What is Dane Church's NPI number?

The NPI number for Dane Church is 1790128387. It was assigned to this individual provider in the NPPES registry on April 12, 2013.

Q: What is Dane Church's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Q: When was this NPI record last updated?

The NPPES record for Dane Church was last updated on April 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 12, 2013PECOS EnrolledAccepts Medicare Assignment

80.53/100

CMS Quality Rating

1301 S KOKE MILL RD, SPRINGFIELD, IL 62711(217) 547-9100(217) 547-9236 Get Directions Write a Review

NPPES record last updated: April 13, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 13, 2020, Aug 1, 2019, Jun 5, 2019 (3 updates tracked since 2019).

On this page

About Dane Jack Church Md NPPES

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

DANE JACK CHURCH MD (NPI 1790128387) is an individual adult reconstructive orthopaedic surgery provider in Springfield, Illinois, licensed in Illinois (036148467) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and maintains a secondary practice location in Kansas City.

NPPES Registry Identity

NPI1790128387

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameDANE JACK CHURCHCredential: MD

Location Address1301 S KOKE MILL RDSpringfield, IL 62711-9252

Mailing Address1301 S Koke Mill RdSpringfield, IL 62711-9252 · (217) 547-9100 · Fax (217) 547-9236

Phone(217) 547-9100

Fax(217) 547-9236

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateApril 12, 2013

Last NPPES UpdateApril 13, 20203 updates tracked since enumeration

NPPES CertifiedApril 13, 2020

✔ NPI 1790128387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

License✔ Licensed in IL · 036148467

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

1301 S KOKE MILL RD, Springfield, IL 62711

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Secondary Practice Location 1

Location 12301 Holmes StKansas City, MO 64108-2640 · Phone (816) 404-4175

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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

Dane Jack Church 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 ID8123320389

PECOS Enrollment IDI20190712002290

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 Dane Church reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orthopaedic Center Of Il

0.3 mi

Orthopaedic Surgery

1301 S KOKE MILL RD
Springfield, IL 62711

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

NPI 1154300572 (217) 547-9100

Orthopaedic Surgery Center Of Illinois, LLC

0.4 mi

Ambulatory Surgical

3136 OLD JACKSONVILLE RD, SUITE 250
Springfield, IL 62704

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

NPI 1760457204 (217) 862-0500

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 17

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, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

3,004 services189 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.

566 services412 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.

366 services221 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

241 services178 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

240 services194 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

194 services157 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.

181 services154 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

83 services78 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

74 services74 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

51 services49 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

50 services33 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

41 services28 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

41 services41 patients

X-ray of both hips, 3-4 views 73522

An X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.

33 services32 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.

26 services26 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

17 services17 patients

Revision of thigh and lower leg bone components of total knee joint prosthesis 27487

This procedure involves replacing parts of your knee joint prosthesis that have worn out or become damaged. Specifically, components in your thigh and lower leg bones are revised to improve joint function and alleviate discomfort.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

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

Memorial Medical Center

Acute Care Hospitals · Springfield, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140148

Location701 N First StSpringfield, IL 62702 · Sangamon County

Emergency services Birthing friendly

Mason District Hospital

Critical Access Hospitals · Havana, IL

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141313

Location615 North Promenade Street,p O Box 530Havana, IL 62644 · Mason County

Emergency services

Hillsboro Area Hospital

Critical Access Hospitals · Hillsboro, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141332

Location1200 E Tremont StreetHillsboro, IL 62049 · Montgomery County

Emergency services

Taylorville Memorial Hospital

Critical Access Hospitals · Taylorville, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number141339

Location201 East Pleasant StreetTaylorville, IL 62568 · Christian County

Emergency services

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.

80.53/100

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

Scored as part of a group practice

Quality

78.39

Improvement Activities

Cost

74.72

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

5 suppliers40 claims40 services$58.86 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 20

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

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