PHILIP GARCIA M.D.
NPI 1831295815
Otolaryngology in Springfield, IL

Q: What is Philip Garcia's NPI number?

The NPI number for Philip Garcia is 1831295815. It was assigned to this individual provider in the NPPES registry on September 16, 2006.

Q: What is Philip Garcia's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Philip Garcia was last updated on May 22, 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 September 16, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

1025 S 6TH ST, SPRINGFIELD, IL 62703(217) 528-7541 Get Directions Write a Review

NPPES record last updated: May 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Philip Garcia M.d. NPPES

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

PHILIP GARCIA M.D. (NPI 1831295815) is an individual otolaryngology provider in Springfield, Illinois, licensed in Illinois (036-086164) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of University Of Michigan Medical School (1987).

NPPES Registry Identity

NPI1831295815

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NamePHILIP GARCIACredential: M.D.

Location Address1025 S 6TH STSpringfield, IL 62703-2403

Mailing Address1025 S 6th StSpringfield, IL 62703-2403 · (217) 528-7541 · Fax (217) 528-8962

Phone(217) 528-7541

Sole ProprietorNo

Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1987

Enumeration DateSeptember 16, 2006

Last NPPES UpdateMay 22, 2020

NPPES CertifiedMay 22, 2020

✔ NPI 1831295815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in IL · 036-086164

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

1025 S 6TH ST, Springfield, IL 62703

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Other Identifiers 1

Medicaid036086164IL

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

Philip Garcia M.d. 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 ID1658277066

PECOS Enrollment IDI20060109000611

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 12

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 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.

331 services268 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.

151 services128 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.

100 services100 patients

Exam of ear using a microscope 92504

An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.

74 services66 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.

71 services71 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

44 services43 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

34 services30 patients

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.

23 services20 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

13 services12 patients

Removal or exploration of parathyroid glands 60500

The procedure for removal or exploration of parathyroid glands involves a surgeon making a small incision in the neck to locate and remove one or more of the tiny parathyroid glands. These glands control calcium levels in the body. This procedure helps treat conditions like hyperparathyroidism.

12 services12 patients

Incision of eardrum with insertion of eardrum tube under local or topical anesthesia 69433

This procedure, known as a Myringotomy with Tube Insertion, involves making a small incision in the eardrum to drain fluid and relieve pressure. A tiny tube is then placed in the eardrum to prevent future fluid buildup. It's done under local or topical anesthesia.

12 services11 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This 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.

12 services11 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

St Marys Hospital

Acute Care Hospitals · Decatur, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140166

Location1800 E Lake Shore DrDecatur, IL 62521 · Macon County

Emergency services Birthing friendly

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62703 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

75/100

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

Scored through an Alternative Payment Model

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.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

9 suppliers20 claims20 services$41.60 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

7 suppliers18 claims18 services$90.68 avg. paid by Medicare

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

DME-Other DME · category DE001N

6 suppliers15 claims37 services$35.77 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers19 claims19 services$59.48 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

9 suppliers31 claims31 services$19.47 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers13 claims13 services$15.48 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.

JEREMY ELLIOTT

Nurse Practitioner (Family)