Active NPI 1154331411 Individual Practitioner Male Practitioner

Dr. Kevin D Malone , MD

Surgery • Effingham, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Kevin Malone, MD is a certified Surgery practicing in Effingham, IL. With approximately 35 years of clinical experience since graduating from Wayne State University School Of Medicine in 1991, Dr. Malone delivers high-quality medical care to the local community at 1104 W EVERGREEN AVE.

Dr. Malone is affiliated with Sarah Bush Lincoln Health Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, biopsy of large bowel using an endoscope, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1104 W Evergreen Ave

Effingham, IL 624011710

Telephone 2173472500

Fax 2173429775

Associated Practice Facility / Clinic

🏢 The Fifer Center For Plastic Surgery Ltd Facility NPI 1083711287

Medicare Profile & Education

Medical School

Wayne State University School Of Medicine

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Effingham, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

35 Yrs +5.2 yrs vs City Avg

City Avg: 29.8 Yrs

State Avg: 27.3 Yrs

Regional Practice Density

6 Specialists

Practicing in Effingham, IL (1624 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

84.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Malone (35 Years) 35 Yrs

Effingham Specialty Average (29.8 Years) 29.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	201	178	$191.82	$74.25
45380 Biopsy of large bowel using an endoscope	135	133	$1698.27	$164.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	89	75	$283.18	$102.31
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	41	40	$1040.00	$131.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$279.03	$94.21
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	24	23	$2194.88	$251.66
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	24	24	$1345.00	$179.44
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	23	11	$464.52	$78.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$452.68	$142.74
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	17	$761.35	$129.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	113	92	$177.73	$87.92
45380 Biopsy of large bowel using an endoscope	102	100	$1634.50	$161.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	92	77	$265.23	$124.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	44	44	$257.82	$109.77
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	37	34	$1003.54	$134.33
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	21	21	$2105.29	$250.62
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$579.29	$129.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	151	129	$252.70	$125.31
45380 Biopsy of large bowel using an endoscope	112	111	$1569.34	$173.49
99213 Established patient office or other outpatient visit, typically 15 minutes	62	54	$155.27	$88.49
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	39	17	$242.59	$70.46
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	36	35	$966.11	$116.99
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$248.31	$110.03
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	21	$443.00	$133.52
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$411.48	$164.95
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	17	17	$1245.94	$185.82
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$161.00	$71.32
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	13	13	$2031.08	$253.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	152	118	$245.20	$126.81
45380 Biopsy of large bowel using an endoscope	142	140	$1512.54	$185.84
99213 Established patient office or other outpatient visit, typically 15 minutes	96	81	$148.63	$88.82
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	54	25	$234.93	$69.92
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	52	51	$928.63	$89.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	45	45	$232.56	$110.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	39	39	$397.21	$165.54
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	33	33	$423.70	$127.16
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	20	20	$1219.00	$186.74
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	16	16	$1928.94	$254.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	118	88	$231.34	$104.59
45380 Biopsy of large bowel using an endoscope	114	114	$1448.86	$179.15
99213 Established patient office or other outpatient visit, typically 15 minutes	89	77	$142.82	$73.21
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	54	52	$884.39	$107.53
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	43	42	$405.37	$139.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$225.24	$106.50
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	31	18	$222.26	$72.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$379.50	$163.50
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	18	18	$1864.56	$263.17
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	18	18	$1153.83	$191.84
45378 Diagnostic exam of large bowel using a flexible endoscope	12	12	$1147.50	$191.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
45380 Biopsy of large bowel using an endoscope	161	155	$1524.63	$177.92
99213 Established patient office or other outpatient visit, typically 15 minutes	129	100	$140.96	$71.98
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	81	46	$160.52	$72.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	81	72	$223.07	$105.51
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	62	56	$1064.60	$133.02
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	50	50	$383.74	$137.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$364.13	$162.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	34	34	$245.56	$106.38
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	30	29	$2188.20	$265.79
99221 Initial hospital inpatient care per day, typically 30 minutes	17	16	$170.53	$102.06
45378 Diagnostic exam of large bowel using a flexible endoscope	16	16	$1467.06	$186.98
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	15	15	$1161.27	$192.90
36589 Removal of central venous catheter for infusion	12	12	$760.67	$165.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	184	141	$151.80	$65.70
45380 Biopsy of large bowel using an endoscope	150	150	$1861.00	$178.22
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	91	54	$158.46	$68.87
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	69	69	$262.00	$96.80
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	59	55	$1576.07	$121.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	54	$224.21	$98.35
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	52	50	$377.23	$125.63
45378 Diagnostic exam of large bowel using a flexible endoscope	41	41	$1692.00	$171.56
99221 Initial hospital inpatient care per day, typically 30 minutes	41	40	$174.61	$97.40
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	21	21	$3100.00	$248.11
99231 Follow-up hospital inpatient care per day, typically 15 minutes	14	12	$112.43	$37.15
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)	12	12	$696.00	$95.91
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$1060.00	$113.85
36589 Removal of central venous catheter for infusion	11	11	$1318.00	$152.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	228	167	$121.82	$64.71
45380 Biopsy of large bowel using an endoscope	147	143	$1861.00	$165.90
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	89	42	$200.00	$66.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	78	$176.00	$97.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	79	79	$233.00	$96.70
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	76	72	$1179.00	$114.64
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	61	61	$357.00	$126.53
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	20	19	$2369.00	$245.23
45378 Diagnostic exam of large bowel using a flexible endoscope	16	16	$1692.00	$178.43
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	12	12	$4013.00	$297.21

Medical Specialties & State Licenses

CMS Verified: 2021-09-07

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IL 036092819

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036092819 (IL)

Hospital & Practice Group Affiliations

Sarah Bush Lincoln Health Center

101 Professional Plz, Mattoon, IL 619389252

Phone: 2172383730

Sarah Bush Lincoln Health Center

1000 Health Ctr Dr, Mattoon, IL 619384644

Sarah Bush Lincoln Health Center

1104 W Evergreen Ave, Effingham, IL 624011710

Phone: 2172347000

Sarah Bush Lincoln Health Center

904 W Temple Ave, Effingham, IL 624012178

Phone: 2173421234

Sarah Bush Lincoln Health Center

503 N Maple, Effingham, IL 624012006

Phone: 2173422121

Secondary Practice Locations

220 S Park Ave Fl 3

Herrin, IL 629483602

Phone: 6189422002

900 W Temple Ave, Suite 101

Effingham, IL 624012186

Phone: 2173472500

904 W Temple Ave

Effingham, IL 624012178

Phone: 2173421234

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Christina Probst , RN

Registered Nurse - Medical-Surgical

NPI 1114121878

Registered Nurse

Kari Fulk , RN, BSN

Registered Nurse - Registered Nurse First Assistant

NPI 1275918393

Registered Nurse, Bachelor of Science in Nursing

Brandi Wood , LPN

Licensed Practical Nurse

NPI 1598998981

Licensed Practical Nurse

Kayla Mummel , RN

Registered Nurse - Registered Nurse First Assistant

NPI 1649703141

Registered Nurse

Susan Logan , RN

Registered Nurse - Medical-Surgical

NPI 1720282486

Registered Nurse

Daniel Shadle , RN

Registered Nurse

NPI 1740439504

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location May 01, 2019

Registered at 1104 W EVERGREEN AVE, EFFINGHAM, IL 624011710 (Tel: 2173472500)

📍

Updated Business Mailing Address March 28, 2019

Registered at 1005 HEALTH CENTER DR STE 201, MATTOON, IL 619384693 (Tel: 2172386055)

✅

NPI Profile Active January 18, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location January 18, 2018

Registered at 900 W TEMPLE AVE, SUITE 101, EFFINGHAM, IL 624012186 (Tel: 2173472500)

📍

Updated Business Mailing Address January 18, 2018

Registered at 900 W TEMPLE AVE, SUITE 101, EFFINGHAM, IL 624012186 (Tel: 2173472500)

👤

Provider Name / Credentials Updated January 18, 2018

Recorded as KEVIN MALONE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 18, 2018

Surgery (License #036092819 in IL)

✅

NPI Profile Active November 19, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location November 19, 2014

Registered at 900 W TEMPLE AVE, SUITE 101, EFFINGHAM, IL 624012186 (Tel: 2173472500)

📍

Updated Business Mailing Address November 19, 2014

Registered at 900 W TEMPLE AVE, SUITE 101, EFFINGHAM, IL 624012186 (Tel: 2173472500)

👤

Provider Name / Credentials Updated November 19, 2014

Recorded as KEVIN MALONE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 19, 2014

Surgery (License #036092819 in IL)

🟢

Initial NPI Registration & Enumeration August 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154331411

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 09, 2006

Last Update: September 07, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1005 Health Center Dr Ste 201

Mattoon, IL 619384693

Phone: 2172386055

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.