HOWARD JAY ILIVICKY (M.D.) – Psychiatry Physician, NPI 1093711152
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
819 PSYCHIATRY in MO
Provider Addresses for HOWARD JAY ILIVICKY (M.D.)
4132 KEATON CROSSING BLVD
STE 201
O FALLON, MO 633688222
Phone: (636) 244-3589
Fax: (636) 244-3594
Type: Mailing
330 1ST CAPITOL DR
STE 390
SAINT CHARLES, MO 633012852
Phone: (636) 949-5760
Fax: (636) 949-0729
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 404 Open Payments records for all available years, with a total value of $12,962.
Total Amount is formed as General ($12,962) + Research ($0) + Ownership ($0) = $12,962.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($6,479).
Total Amount
$12,962
General + Research + Ownership
Payments
404
Total payment records
General Amount
$12,962
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2025-04-28
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 |
|---|---|---|---|---|
| I20130513000277 | I | Psychiatry | MO | TBD |
| I20250428001065 | I | Psychiatry | WA | 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 | 435 | 149 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 50 | 38 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 11 | 11 | $0 |
Insurance plans in this area (ZIP 63368)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | MO | 90792 | Psychiatric diagnostic evaluation with medical services | 18 | 18 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | WA | |
| P S Y C H I A T R Y | WA | |
| P S Y C H I A T R Y | WA | |
| Nurse Practitioner | SC | |
| Nurse Practitioner | UT | |
| P S Y C H I A T R Y | WA | |
| Nurse Practitioner | WA |
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