DAVID MATHERN PA
NPI 1790896306
Physician Assistant in Aurora, IL
NPI Status: Active since August 31, 2006
Contact Information
2111 OGDEN AVE
AURORA, IL
ZIP 60504
Phone: (630) 978-3800
- Individual
- Male
- Years of Experience 19
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About DAVID MATHERN
This page provides the complete NPI Profile along with additional information for David Mathern, a primary care provider established in Aurora, Illinois with a medical specialization in Physician Assistant and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1790896306 assigned on August 2006. The practitioner's primary taxonomy code is 363A00000X with license number 085002781 (IL). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1790896306
- Provider Name
- DAVID MATHERN PA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2111 OGDEN AVE AURORA, IL 60504
- Location Phone
- (630) 978-3800
- Mailing Address
- 2111 OGDEN AVE AURORA, IL 60504
- Medical School Name
- OTHER
- Graduation Year
- 2007
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-31-2006
- Last Update Date
- 08-02-2022
- Code Navigator
A primary care provider (PCP) like David Mathern sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 085002781
- License State
- IL
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 085002781 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Precision Bronze HMO? 701 - HMO
- Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
- Blue Precision Gold HMO? 207 - HMO
- Blue Precision Gold HMO? 703 - HMO
- Blue Precision Gold HMO? Standard - Rx Copays - HMO
- Blue Precision Silver HMO? 206 - HMO
- Blue Precision Silver HMO? 704 - HMO
- Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
- MyBlue Plus Bronze? 903 - POS
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 with Rx Copay - HMO
- Silver 1 - HMO
- Silver 1 with Rx Copay and Adult Vision Services - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 8 - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (Rx Copay, No Referrals) - HMO
- UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus (No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
David Mathern is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
David Mathern is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 6002815701
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20061206000438
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Aspiration and/or injection of fluid large joint using ultrasound guidance
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Hip replacement
Hyaluronan or derivative, gel-one, for intra-articular injection, per dose
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Knee replacement
New patient office or other outpatient visit, 30-44 minutes
Replacement of knee joint, both sides of knee
Replacement of thigh bone and hip joint with prosthesis
X-ray of hip, 2-3 views
X-ray of knee, 3 views
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.
This service was performed 46 times for 33 patientsThis procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
This service was performed 60 times for 47 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 24 times for 19 patientsThis 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.
This service was performed 117 times for 106 patientsThis 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.
This service was performed 68 times for 64 patientsA hip replacement is a surgical procedure where a worn-out or damaged hip joint is replaced with an artificial one. This procedure can greatly reduce pain and improve mobility. It's often recommended when other treatments like physical therapy or medications fail to alleviate symptoms.
This service was performed for 1-10 patientsHyaluronan 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.
This service was performed 49 times for 39 patientsThis injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
This service was performed 92 times for 15 patientsTriamcinolone 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.
This service was performed 280 times for 48 patientsA knee replacement is a surgical procedure where a damaged or diseased knee joint is replaced with an artificial one. This can relieve pain and improve mobility. The procedure involves removing damaged parts of the knee and inserting a prosthetic joint. Recovery may take several weeks.
This service was performed for 1-10 patientsThis 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.
This service was performed 12 times for 12 patientsA 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.
This service was performed 61 times for 60 patientsThis 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.
This service was performed 33 times for 33 patientsAn 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.
This service was performed 24 times for 23 patientsAn 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.
This service was performed 37 times for 35 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.25 for a new patient copayment and $18.59 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 60504 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $93.02
- Minimum New Patient Price $59.81
- Maximum New Patient Price $181.38
- Average New Patient Copayment $23.25
- Minimum New Patient Copayment $14.95
- Maximum New Patient Copayment $45.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.38
- Minimum Established Patient Price $19.15
- Maximum Established Patient Price $147.12
- Average Established Patient Copayment $18.59
- Minimum Established Patient Copayment $4.78
- Maximum Established Patient Copayment $36.78
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
Quality Measure | Performance | Number of Patients |
---|---|---|
Documentation of Current Medications in the Medical Record | 98% | 375 |
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
e-Prescribing | 51% | 220 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Falls: Screening for Future Fall Risk | 99% | 155 |
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
Medication Reconciliation | 96% | 346 |
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
Participation in CAHPS or other supplemental questionnaire | Yes | N/A |
Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets). | ||
Patient-Specific Education | 26% | 375 |
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
Pneumococcal Vaccination Status for Older Adults | 65% | 155 |
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 42% | 288 |
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
Preventive Care and Screening: Influenza Immunization | 96% | 70 |
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
Provide Patient Access | 95% | 375 |
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
Security Risk Analysis | Yes | N/A |
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Specialized Registry Reporting | Yes | N/A |
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
Tobacco use | Yes | N/A |
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Mathern is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
COPLEY MEMORIAL HOSPITAL | 2000 OGDEN AVENUE AURORA, IL 60504 | (630) 978-6200 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 7 | 9 | 0 | 8 | 9 | 6 | 3 | 0 | 6 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 18 | 0 | 16 | 9 | 12 | 3 | 0 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 8 + 0 + 1 + 6 + 9 + 1 + 2 + 3 + 0 + 24 = 64 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 64 = 6 | 6 |
The NPI number 1790896306 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. THOMAS RICHARD HUBERTY M.D.
Orthopaedic Surgery
2111 OGDEN AVE
AURORA, IL
ZIP 60504
PAUL F WITT M.D.
Specialist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
CASTLE ORTHOPAEDICS & SPORTS MEDICINE, S.C.
Specialist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
KRISTINA QUICK BRAUN PT
Physical Therapist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MRS. CAROL A MCGUIRE R.N.
Registered Nurse
(Orthopedic)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MS. MARY FARRELL MILROY R.N.
Registered Nurse
(Orthopedic)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MARY D RENNER NURSE
Registered Nurse
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MR. WAYNE BLUME R.N.
Registered Nurse
(Orthopedic)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MRS. FRANCES WIRTZ R.N.
Registered Nurse
(Orthopedic)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
CASTLE ORTHOPAEDICS AND SPORTS MEDICINE
Registered Nurse
(Orthopedic)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
RUSH-COPLEY SURGICENTER, LLC
Clinic/Center
(Ambulatory Surgical)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
RUSH-COPLEY ORTHOPEDICS, LLC
Orthopaedic Surgery
2111 OGDEN AVE
AURORA, IL
ZIP 60504
HWOV, L.L.C.
Clinic/Center
(Ambulatory Surgical)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MR. RICHARD S GORYL PHYSICAL THERAPIST
Physical Therapist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
RYAN LIFKA DPT
Physical Therapist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MR. THOMAS JOSEPH BENOIT P.T.
Physical Therapist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
DR. STEVEN A MARCINIAK MD
Orthopaedic Surgery
(Sports Medicine)
2111 OGDEN AVE
AURORA, IL
ZIP 60504
KAREN DONOVAN OT
Occupational Therapist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
MR. KEITH EDWARD CHAMPEN PT
Physical Therapist
2111 OGDEN AVE
AURORA, IL
ZIP 60504
DR. SACHIN KUMAR BANSAL M.D.
Physical Medicine & Rehabilitation
2111 OGDEN AVE
AURORA, IL
ZIP 60504
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790896306, enumerated as an "individual" on August 31, 2006.
The provider is located at 2111 OGDEN AVE AURORA, IL 60504 and the phone number is (630) 978-3800.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to verify.
David Mathern is affiliated with: COPLEY MEMORIAL HOSPITAL.