Unknown Individual – Internal Medicine Physician, NPI 1265408694
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
231, Raptor Court, Forsyth, Macon County, Illinois, 62535, United States
FORSYTH, IL 625359674
Phone: (217) 791-6703
Fax: (217) 791-6976
Type: Mailing
The Decatur Professional Plaza, 363, South Main Street, Central Business District, Decatur, Macon County, Illinois, 62523, United States
SUITE 345
DECATUR, IL 625231412
Phone: (217) 791-6703
Fax: (217) 791-6976
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $90.
Total Amount is formed as General ($90) + Research ($0) + Ownership ($0) = $90.
Last reported payment date: 2024-01-18 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($90).
Total Amount
$90
General + Research + Ownership
Payments
2
Total payment records
General Amount
$90
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $90 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 397 | 63 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 340 | 101 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 24 | 16 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 23 | 22 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 21 | 18 | $0 |
Insurance plans in this area (ZIP 62535)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INFECTIOUS DISEASE | IL | 90792 | Psychiatric diagnostic evaluation with medical services | 26 | 25 |
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