JACK P SPANIOL (MD) – Family Medicine Physician, NPI 1356379184
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,037 FAMILY PRACTICE in IL
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Provider Addresses for JACK P SPANIOL (MD)
308, Saint Joseph Drive, Bloomington, McLean County, Illinois, 61701, United States
BLOOMINGTON, IL 617013506
Phone: (309) 663-5050
Fax: (309) 662-3401
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $305.
Total Amount is formed as General ($305) + Research ($0) + Ownership ($0) = $305.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Lundbeck LLC ($123).
Total Amount
$305
General + Research + Ownership
Payments
3
Total payment records
General Amount
$305
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lundbeck LLC | $123 |
| AIMMUNE THERAPEUTICS, INC. | $115 |
| Phathom Pharmaceuticals, Inc. | $67 |
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: 2006-10-12
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 |
|---|---|---|---|---|
| I20061012000384 | I | Family Practice | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 700 | 271 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 182 | 138 | $0 |
| G0008 | Administration of influenza virus vaccine | 90 | 89 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 86 | 65 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 85 | 84 | $0 |
Insurance plans in this area (ZIP 61701)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | TN | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MO | |
| - | IL |
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