PAUL G MALCHAREK MD
NPI 1891781951
Internal Medicine in Maryville, IL

Q: What is Paul Malcharek's NPI number?

The NPI number for Paul Malcharek is 1891781951. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Q: What is Paul Malcharek's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Paul Malcharek was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 23, 2005PECOS EnrolledAccepts Medicare Assignment

94.61/100

CMS Quality Rating

2401 S CENTER ST, MARYVILLE, IL 62062(618) 344-3046(618) 344-5284 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 6, 2022, Apr 23, 2020, Dec 18, 2018 (3 updates tracked since 2018).

On this page

About Paul G Malcharek Md NPPES

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

PAUL G MALCHAREK MD (NPI 1891781951) is an individual internal medicine provider in Maryville, Illinois, licensed in Illinois (036093757) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Illinois Medical College (1994).

NPPES Registry Identity

NPI1891781951

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NamePAUL G MALCHAREKCredential: MD

Location Address2401 S CENTER STMaryville, IL 62062-5401

Mailing Address2401 S Center StMaryville, IL 62062-5401 · (618) 344-3046 · Fax (618) 344-5284

Phone(618) 344-3046

Fax(618) 344-5284

Sole ProprietorNo

Medical School CMSIllinois Medical CollegeGraduated 1994

Enumeration DateSeptember 23, 2005

Last NPPES UpdateJanuary 6, 20223 updates tracked since enumeration

NPPES CertifiedJanuary 6, 2022

✔ NPI 1891781951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036093757

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2401 S CENTER ST, Maryville, IL 62062

Open in Google Maps ↗

Other Identifiers 1

Medicaid036093757IL

Accepted Insurance

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

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

Paul G Malcharek 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 ID4587640263

PECOS Enrollment IDI20040624001142

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 Reassignment

Medicare enrollment records show Paul Malcharek reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sjl Health Systems Inc

65 mi

Skilled Nursing Facility

900 S CHESTNUT ST
Pana, IL 62557

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Hshs Medical Group Inc
317 clinicians in this Medicare group

NPI 1215037353 (217) 562-3996

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 26

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.

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.

523 services211 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.

442 services238 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

279 services108 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.

217 services96 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.

137 services101 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

110 services49 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

99 services80 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

93 services33 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

78 services45 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.

74 services29 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

65 services27 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

62 services62 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

57 services57 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

50 services26 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.

49 services48 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

43 services22 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

42 services23 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

41 services14 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

38 services14 patients

X-ray of upper arm, minimum of 2 views 73060

An X-ray of the upper arm with a minimum of 2 views involves capturing images of your arm from different angles. This helps in assessing the bones and surrounding tissues for any abnormalities or injuries. It's a quick, painless procedure.

30 services12 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

23 services18 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

19 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

18 services18 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

18 services17 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

18 services18 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

15 services13 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 Hospital

Acute Care Hospitals · Belleville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140185

Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County

Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

Anderson Hospital

Acute Care Hospitals · Maryville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140289

Location6800 State Route 162Maryville, IL 62062 · Madison County

Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number141336

Location12866 Troxler AvenueHighland, IL 62249 · Madison County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 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

$131.14 typical visit price

range $56.28 – $173.35

Typical copayment $32.78 (range $14.07 – $43.33)

Most-billed visit code 99204

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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.

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.

94.61/100

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

Scored through an Alternative Payment Model

Quality

85.17

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 8

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

15 suppliers46 claims108 services$6.23 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers17 claims22 services$1.08 avg. paid by Medicare

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

DME-Other DME · category DE001N

4 suppliers11 claims11 services$71.55 avg. paid by Medicare

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

DME-Other DME · category DE001N

4 suppliers11 claims28 services$27.62 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers12 claims12 services$15.73 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers18 claims107 services$1.55 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 4

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

DR. ZACHARY PAUL LUCHTEFELD D.O.

Family Medicine

2401 S CENTER ST
MARYVILLE, IL 62062

Madison County (618) 344-3046

MRS. AMANDA JOY KILZER FNP-C

Nurse Practitioner (Family)

2401 S CENTER ST
MARYVILLE, IL 62062

Madison County (618) 344-3046

COURTNEY LEIGH GARRISON

Nurse Practitioner

2401 S CENTER ST
MARYVILLE, IL 62062

Madison County (618) 344-3046

MRS. HOLLY HARLOW SHIRLEY N.P.

Nurse Practitioner

2401 S CENTER ST
MARYVILLE, IL 62062

Madison County (618) 344-3046

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 Paul Malcharek's NPI number?

The NPI number for Paul Malcharek is 1891781951. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Paul Malcharek located?

Paul Malcharek practices at 2401 S Center St, Maryville, IL 62062. The listed phone number is (618) 344-3046.

What is Paul Malcharek's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Paul Malcharek enrolled in Medicare?

Yes. Paul Malcharek is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Paul Malcharek's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Malcharek reassigns Medicare benefits to Sjl Health Systems Inc (Pana, IL). The 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 Paul Malcharek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Malcharek accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Medica and UnitedHealthcare list Paul Malcharek 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.

Is Paul Malcharek affiliated with any hospitals?

According to CMS data, Paul Malcharek is affiliated with St Johns Hospital, Memorial Hospital, Hshs St Elizabeth's Hospital, Anderson Hospital and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Paul Malcharek was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.