MICHAEL MARTIN MCGUIRE (PA-C, ATC) – Physician Assistant, NPI 1164931960
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MICHAEL MARTIN MCGUIRE (PA-C, ATC)
670 PIERCE BLVD
O FALLON, IL 622692579
Phone: (618) 206-2094
Fax: (618) 607-5127
Type: Mailing
670 PIERCE BLVD STE 200
O FALLON, IL 622692579
Phone: (618) 206-2094
Type: Location
Farnham Street, Cazenovia, Town of Cazenovia, Madison County, New York, 13035, United States
CAZENOVIA, NY 130351153
Phone:
Type: Mailing
13, Oak Drive, Hamilton, Town of Hamilton, Madison County, New York, 13346, United States
HAMILTON, NY 133461386
Phone: (315) 228-6399
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251009000644 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62269)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Family Practice | IL | |
| G A S T R O E N T E R O L O G Y | TX | |
| Internal Medicine | IL | |
| General Surgery | IL | |
| - | IL | |
| General Surgery | IL | |
| Family Practice | IL | |
| - | IL | |
| - | IL |
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