MR. THOMAS WAYNE MOLL (LCSW) – Clinical Social Worker, NPI 1053459503
Clinical Social Worker
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. THOMAS WAYNE MOLL (LCSW)
PO BOX 144
HERRICK, IL 624310144
Phone: (217) 343-9079
Type: Location
1025, South 6th Street, South Town, Springfield, Sangamon County, Illinois, 62703, United States
SPRINGFIELD, IL 627032403
Phone: (217) 528-7541
Type: Mailing
1280, East Tremont Street, Hillsboro Heights, Hillsboro, Montgomery County, Illinois, 62049, United States
HILLSBORO, IL 620491912
Phone: (217) 528-7541
Type: Location
PO BOX 19248
SPRINGFIELD, IL 627949248
Phone: (217) 528-7541
Type: Mailing
300 N MAPLE ST
EFFINGHAM, IL 624012003
Phone: (217) 342-4151
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2005-03-24
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 |
|---|---|---|---|---|
| I20050324000233 | I | Clinical Social Worker | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62431)
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