STATE STREET CENTER
NPI 1811054935
Clinic/Center - Federally Qualified Health Center (FQHC) in East Saint Louis, IL
About State Street Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STATE STREET CENTER (NPI 1811054935) is a healthcare organization registered as a federally qualified health center (fqhc) in East Saint Louis, Illinois and active in the NPI registry since January 2007. The organization lists Larry Mcculley, Chief Operating Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Names 1
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
State Street Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
164Medicare enrollment records show 164 clinicians reassign Medicare billing to State Street Center, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 54 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 15
Nearest to this location (20)
See all 164Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Southern Illinois Healthcare Foundation, Inc.'s NPI number?
The NPI number for Southern Illinois Healthcare Foundation, Inc. is 1811054935. It was assigned to this organization in the NPPES registry on January 2, 2007. The provider is doing business as State Street Center.
Where is Southern Illinois Healthcare Foundation, Inc. located?
Southern Illinois Healthcare Foundation, Inc. is located at 2001 State St, East Saint Louis, IL 62205. The listed phone number is (618) 271-9191.
What is Southern Illinois Healthcare Foundation, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Southern Illinois Healthcare Foundation, Inc. enrolled in Medicare?
Yes. Southern Illinois Healthcare Foundation, Inc. is registered in the Medicare PECOS enrollment system.
When is Southern Illinois Healthcare Foundation, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Illinois, Federally Qualified Health Center (FQHC)) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southern Illinois Healthcare Foundation, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 164 clinicians in 15 Medicare specialties reassign their Medicare billing to Southern Illinois Healthcare Foundation, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (57), Family Practice (43) and Internal Medicine (16). Of these, 9 practice at this address and 54 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southern Illinois Healthcare Foundation, Inc. accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Medica list Southern Illinois Healthcare Foundation, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Illinois Healthcare Foundation, Inc. was last updated on October 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# State Street Center · NPI 1811054935
Federally Qualified Health Center (FQHC) organization in East Saint Louis, Illinois. Organization record, active in the CMS NPPES registry since January 2, 2007.
## Identity
- **NPI:** 1811054935 (Entity type: Organization)
- **Enumerated:** January 2, 2007
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Southern Illinois Healthcare Foundation, Inc.
- **Organization subpart:** No
- **Authorized official:** Larry Mcculley, CHIEF OPERATING OFFICER
## Practice location
- **Address:** 2001 STATE ST, East Saint Louis, IL 62205-1803
- **Phone:** (618) 271-9191 · **Fax:** (618) 271-9617
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Part A, Illinois, Federally Qualified Health Center (FQHC)) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 164 clinicians in 15 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (57), Family Practice (43), Internal Medicine (16); 9 practice at this address and 54 within 10 miles; [full list](https://npiprofile.com/npi/1811054935/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 30, 2008
- **Other identifiers:** Medicare ID-Type Unspecified 732740 (IL); Medicare ID-Type Unspecified 141843 (IL); Medicaid =========003 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1811054935) · Data from the CMS NPPES public registry.