DANE JACK CHURCH (MD) – Adult Reconstructive Orthopaedic Surgery Physician, NPI 1790128387
Adult Reconstructive Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
802 ORTHOPEDIC SURGERY in MO
Provider Addresses for DANE JACK CHURCH (MD)
2301 Holmes St
Kansas City, MO 641082640
Phone: (816) 404-4175
Type: Location
1301 S KOKE MILL RD
SPRINGFIELD, IL 627119252
Phone: (217) 547-9100
Fax: (217) 547-9236
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 35 Open Payments records for all available years, with a total value of $5,240.
Total Amount is formed as General ($5,240) + Research ($0) + Ownership ($0) = $5,240.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($5,150).
Total Amount
$5,240
General + Research + Ownership
Payments
35
Total payment records
General Amount
$5,240
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Zimmer Biomet Holdings, Inc. | $5,150 |
| Orthofix Medical, Inc. | $56 |
| Heron Therapeutics, Inc. | $20 |
| DePuy Synthes Sales 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: 2019-07-12
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 |
|---|---|---|---|---|
| I20190712002290 | I | Orthopedic Surgery | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 3,044 | 178 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 673 | 482 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 414 | 208 | $0 |
| 73562 | X-ray of knee, 3 views | 289 | 206 | $0 |
| 73502 | X-ray of hip, 2-3 views | 240 | 191 | $0 |
Insurance plans in this area (ZIP 64108)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | IL | |
| P O D I A T R Y | WI | |
| Physician Assistant | IL | |
| Orthopedic Surgery | IL | |
| Physical Medicine And Rehabilitation | IL | |
| Nurse Practitioner | IL | |
| Orthopedic Surgery | MI | |
| Nurse Practitioner | IL | |
| - | IL |
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