DR. SEAN DAVID LATTIMORE (D.O.) – Family Medicine Physician, NPI 1710058961
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
5,037 FAMILY PRACTICE in IL
Provider Addresses for DR. SEAN DAVID LATTIMORE (D.O.)
1000 ELEVEN S STE 4A
COLUMBIA, IL 622361077
Phone: (618) 206-6120
Type: Location
509 Hamacher St
Suite 103
Waterloo, IL 622981592
Phone: (618) 939-2273
Fax: (618) 939-0245
Type: Location
PO BOX 955534
SAINT LOUIS, MO 631955534
Phone:
Type: Mailing
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 $54.
Total Amount is formed as General ($54) + Research ($0) + Ownership ($0) = $54.
Last reported payment date: 2024-02-29 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($40).
Total Amount
$54
General + Research + Ownership
Payments
3
Total payment records
General Amount
$54
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $40 |
| ABBVIE INC. | $14 |
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: 2019-04-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20070911000280 | I | Family Practice | IL | TBD |
| I20190416002054 | I | Family Practice | MO | 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 | 406 | 231 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 153 | 153 | $0 |
| G0008 | Administration of influenza virus vaccine | 22 | 22 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 21 | 21 | $0 |
| 83036 | Hemoglobin a1c level | 21 | 19 | $0 |
Insurance plans in this area (ZIP 62236)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | IL | 85610 | Blood test, clotting time | 113 | 24 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO | |
| - | MO | |
| Interventional Pain Management, Anesthesiology | MO |
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