MILLENNIUM ANESTHESIOLOGY CONSULTANTS, LLC – Anesthesiology Physician, NPI 1710218094
Anesthesiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MILLENNIUM ANESTHESIOLOGY CONSULTANTS, LLC
PO BOX 616
EDWARDSVILLE, IL 620250616
Phone: (833) 749-8324
Fax: (214) 301-0649
Type: Mailing
6800 STATE ROUTE 162
MARYVILLE, IL 620628500
Phone: (618) 391-5589
Fax: (214) 301-0649
Type: Location
Meridian Woods, Glen Carbon, Madison County, Illinois, 62034, United States
GLEN CARBON, IL 620341545
Phone: (618) 391-5883
Type: Location
3687, Wheeler Road, Kingston, Augusta, Richmond County, Georgia, 30909, United States
AUGUSTA, GA 309096521
Phone: (800) 394-4445
Fax: (706) 396-3252
Type: Mailing
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: 2010-06-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (616 days ago).
Enrollment records
1
Earliest due date
2024-09-30
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 |
|---|---|---|---|---|
| O20100630000117 | O | Clinic/Group Practice | IL | 2024-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 62025)
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