DR. THEODORE REXFORD ADDAI M.D.
NPI 1912985185
Internal Medicine - Cardiovascular Disease in Decatur, IL

Active since January 06, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1770 E LAKE SHORE DR STE 105, DECATUR, IL 62521(217) 422-6100(833) 784-5326 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 20, 2021, Dec 10, 2021, Sep 29, 2019 (3 updates tracked since 2019).

About Dr. Theodore Rexford Addai M.d. NPPES

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

DR. THEODORE REXFORD ADDAI M.D. (NPI 1912985185) is an individual cardiovascular disease provider in Decatur, Illinois, licensed in Illinois (036078026) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and maintains a secondary practice location in Decatur.

NPPES Registry Identity

NPI1912985185
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. THEODORE REXFORD ADDAICredential: M.D.
Location Address1770 E LAKE SHORE DR STE 105Decatur, IL 62521-3800
Mailing Address1770 E Lake Shore Dr Ste 105Decatur, IL 62521-3800 · (217) 422-6100 · Fax (833) 784-5326
Fax(833) 784-5326
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateJanuary 6, 2006
Last NPPES UpdateDecember 20, 20213 updates tracked since enumeration
NPPES CertifiedDecember 20, 2021
NPI 1912985185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in IL · 036078026
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedSpecialistTaxonomy 174400000X · License 036078026 (IL)
1770 E LAKE SHORE DR STE 105, Decatur, IL 62521

Secondary Practice Location 1

Location 12965 N Main St Ste EDecatur, IL 62526-4392 · Phone (217) 422-6100

Other Identifiers 2

Medicaid036078026IL
Other000334245IL · Railroad

Accepted Insurance

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

Dr. Theodore Rexford Addai 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 ID7810991338
PECOS Enrollment IDI20060914000039
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 30

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.

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
321 services305 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.
261 services249 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.
234 services187 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
222 services194 patients
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days 93296
This procedure involves remotely monitoring your pacemaker or implantable defibrillator system. Over a 90-day period, we check the device's performance and your heart's activity. This helps ensure the device is functioning properly and providing the best possible support for your heart health.
126 services53 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
122 services78 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

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140135
Location2300 North Edward StreetDecatur, IL 62526 · Macon 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

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140189
Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County
Emergency services Birthing friendly

Hshs Good Shepherd Hospital Inc

Critical Access Hospitals · Shelbyville, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141354
Location200 S Cedar StShelbyville, IL 62565 · Shelby County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62521 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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 12

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

Internal Medicine (Cardiovascular Disease)
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Nurse Practitioner (Family)
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Surgery
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Physician Assistant
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Internal Medicine (Interventional Cardiology)
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Internal Medicine (Interventional Cardiology)
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Physician Assistant (Medical)
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521
Nurse Practitioner (Family)
1770 E LAKE SHORE DR STE 105
DECATUR, IL 62521

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 Theodore Addai's NPI number?

The NPI number for Theodore Addai is 1912985185. It was assigned to this individual provider in the NPPES registry on January 6, 2006.

Where is Theodore Addai located?

Theodore Addai practices at 1770 E Lake Shore Dr Ste 105, Decatur, IL 62521. The listed phone number is (217) 422-6100.

What is Theodore Addai's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Theodore Addai enrolled in Medicare?

Yes. Theodore Addai 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.

What insurance does Theodore Addai accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Theodore Addai 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 Theodore Addai affiliated with any hospitals?

According to CMS data, Theodore Addai is affiliated with St Johns Hospital, Decatur Memorial Hospital, St Marys Hospital, Sarah Bush Lincoln Health Center and Hshs Good Shepherd Hospital Inc.

When was this NPI record last updated?

The NPPES record for Theodore Addai was last updated on December 20, 2021. 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.