Active NPI 1245765296 Individual Practitioner Female Practitioner

Kelsey Marie Thacker

Nurse Practitioner • Mt Zion, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kelsey Thacker is a certified Nurse Practitioner practicing in Mt Zion, IL. With approximately 10 years of clinical experience since completing medical education in 2016, Kelsey Thacker delivers high-quality medical care to the local community at 104 E ASHLAND AVE.

Kelsey Thacker is affiliated with Decatur Orthopedic Center Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, established patient outpatient office visit, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

104 E Ashland Ave

Mt Zion, IL 625491271

Telephone 2178642665

Fax 2178648042

Associated Practice Facility / Clinic

🏢 Sullivan & Sams Medical, Llc Facility NPI 1295299774

Medicare Profile & Education

Medical School

Other

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Mt Zion, IL

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

10 Yrs +3.0 yrs vs City Avg

City Avg: 7.0 Yrs

State Avg: 10.4 Yrs

Regional Practice Density

4 Specialists

Practicing in Mt Zion, IL (4929 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

93.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Thacker (10 Years) 10 Yrs

Mt Zion Specialty Average (7.0 Years) 7.0 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
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	893	132	$19.98	$0.97
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	202	152	$225.17	$103.80
20610 Aspiration and/or injection of fluid from large joint	170	130	$322.42	$59.16
99213 Established patient office or other outpatient visit, typically 15 minutes	98	86	$149.80	$72.76
73564 X-ray of knee, 4 or more views	94	88	$275.00	$40.72
73030 X-ray of shoulder, minimum of 2 views	69	62	$205.00	$23.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$367.46	$134.69
73502 X-ray of hip, 2-3 views	57	54	$188.00	$33.10
73562 X-ray of knee, 3 views	50	45	$187.00	$32.13
27447 Replacement of knee joint, both sides of knee	44	43	$5422.73	$171.47
27130 Replacement of thigh bone and hip joint with prosthesis	21	20	$5262.36	$171.93
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$248.00	$90.78
23472 Prosthetic repair of shoulder joint, total shoulder	14	14	$4833.21	$192.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	491	75	$19.80	$1.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	104	87	$225.63	$105.10
20610 Aspiration and/or injection of fluid from large joint	93	74	$322.65	$59.88
99213 Established patient office or other outpatient visit, typically 15 minutes	51	47	$150.00	$73.22
73564 X-ray of knee, 4 or more views	51	51	$275.00	$41.10
27447 Replacement of knee joint, both sides of knee	45	43	$11566.67	$174.29
73502 X-ray of hip, 2-3 views	27	26	$188.00	$33.53
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$358.77	$137.85
73030 X-ray of shoulder, minimum of 2 views	25	23	$205.00	$24.67
73562 X-ray of knee, 3 views	23	22	$187.00	$29.74
27130 Replacement of thigh bone and hip joint with prosthesis	17	17	$12986.00	$174.49
23472 Prosthetic repair of shoulder joint, total shoulder	15	15	$10337.00	$196.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	405	65	$19.51	$1.15
99358 Prolonged patient service without direct patient contact first hour	153	147	$395.60	$92.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	126	111	$223.10	$106.42
20610 Aspiration and/or injection of fluid from large joint	82	67	$311.28	$61.49
27447 Replacement of knee joint, both sides of knee	61	59	$10980.36	$176.19
99213 Established patient office or other outpatient visit, typically 15 minutes	61	57	$143.61	$75.44
73562 X-ray of knee, 3 views	47	41	$187.00	$31.91
73564 X-ray of knee, 4 or more views	45	42	$275.00	$45.44
27130 Replacement of thigh bone and hip joint with prosthesis	43	42	$13055.77	$176.22
73030 X-ray of shoulder, minimum of 2 views	36	33	$205.00	$25.39
73502 X-ray of hip, 2-3 views	33	30	$188.00	$33.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$344.89	$139.77
23472 Prosthetic repair of shoulder joint, total shoulder	16	16	$9748.88	$205.66
29827 Repair of shoulder rotator cuff using an endoscope	13	13	$5842.00	$146.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	201	28	$18.76	$1.25
27447 Replacement of knee joint, both sides of knee	57	56	$11552.63	$177.14
99213 Established patient office or other outpatient visit, typically 15 minutes	56	49	$145.36	$76.42
20610 Aspiration and/or injection of fluid from large joint	36	30	$300.00	$61.99
27130 Replacement of thigh bone and hip joint with prosthesis	33	33	$11977.36	$178.77
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$204.62	$94.40
23472 Prosthetic repair of shoulder joint, total shoulder	18	18	$9812.72	$201.10
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	16	15	$6096.31	$24.33
29827 Repair of shoulder rotator cuff using an endoscope	13	12	$5560.69	$148.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$111.15	$44.21
27245 Treatment of broken neck of thigh bone with bone implant	12	12	$6918.00	$170.18
29824 Partial removal of collar bone at shoulder using an endoscope	11	11	$5198.27	$57.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	124	24	$20.00	$1.49
27447 Replacement of knee joint, both sides of knee	56	52	$11364.09	$190.90
99213 Established patient office or other outpatient visit, typically 15 minutes	36	35	$150.00	$62.70
27130 Replacement of thigh bone and hip joint with prosthesis	30	30	$12986.00	$186.56
20610 Aspiration and/or injection of fluid from large joint	26	25	$325.00	$58.02
23472 Prosthetic repair of shoulder joint, total shoulder	22	21	$10405.18	$204.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	21	$115.00	$37.59
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	19	18	$6495.00	$24.80
29824 Partial removal of collar bone at shoulder using an endoscope	15	14	$6395.00	$45.89
29827 Repair of shoulder rotator cuff using an endoscope	14	13	$6056.29	$150.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	216	40	$20.00	$1.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	52	$115.00	$36.79
27447 Replacement of knee joint, both sides of knee	56	53	$11794.64	$185.44
20610 Aspiration and/or injection of fluid from large joint	46	42	$325.00	$55.34
99213 Established patient office or other outpatient visit, typically 15 minutes	28	28	$150.00	$61.00
27130 Replacement of thigh bone and hip joint with prosthesis	25	25	$13286.00	$187.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$252.00	$89.42
23472 Prosthetic repair of shoulder joint, total shoulder	19	19	$10494.89	$200.38
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	15	15	$6295.00	$24.45
29827 Repair of shoulder rotator cuff using an endoscope	12	12	$6133.67	$144.18
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$318.00	$85.70
27236 Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement	11	11	$6730.73	$164.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	190	27	$20.00	$1.79
27447 Replacement of knee joint, both sides of knee	68	63	$13000.00	$186.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	43	$115.00	$35.86
27130 Replacement of thigh bone and hip joint with prosthesis	40	38	$14486.00	$187.03
20610 Aspiration and/or injection of fluid from large joint	34	26	$325.00	$60.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$252.00	$89.24
23472 Prosthetic repair of shoulder joint, total shoulder	20	19	$11837.00	$200.51
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	19	19	$6495.00	$24.51
29824 Partial removal of collar bone at shoulder using an endoscope	16	16	$6495.00	$38.36
29827 Repair of shoulder rotator cuff using an endoscope	15	15	$7342.00	$144.06
23430 Anchoring of biceps tendon	13	12	$5103.00	$50.70
99213 Established patient office or other outpatient visit, typically 15 minutes	12	12	$150.00	$60.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	104	16	$20.00	$1.85
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	38	$115.00	$35.36
27447 Replacement of knee joint, both sides of knee	33	32	$13000.00	$186.27
27130 Replacement of thigh bone and hip joint with prosthesis	18	18	$14486.00	$186.38
20610 Aspiration and/or injection of fluid from large joint	17	16	$497.06	$63.71
23472 Prosthetic repair of shoulder joint, total shoulder	15	15	$11837.00	$199.88
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	11	$421.00	$114.91

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IL 209015926

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Decatur Orthopedic Center Llc

104 E Ashland Ave, Mt Zion, IL 625491271

Phone: 2178642665

Practice Associates & Co-Workers

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

11 Associated Practitioners

Dr. Madeline Mackin , PT, DPT

Physical Therapist

NPI 1033843693

Physical Therapist, Doctor of Physical Therapy

Stephanie Mcgeorge , BSN RN CNOR RNFA

Registered Nurse - Orthopedic

NPI 1114388543

BSNRNCNORRNFA

Dr. Donald Sullivan , MD

Orthopaedic Surgery

NPI 1154511517

Doctor of Medicine (M.D.)

Dana Young , BSN, RN, CNOR, RNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1588040349

Bachelor of Science in Nursing, Registered Nurse, CNOR, RNFA

Megan Musick , MPT

Physical Therapist

NPI 1609139609

Master of Physical Therapy

Maddison Maxedon , APRN

Nurse Practitioner

NPI 1629862982

Advanced Practice Registered Nurse

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active April 27, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 27, 2017

Registered at 104 E ASHLAND AVE, MT ZION, IL 625491271 (Tel: 2178642665)

📍

Updated Business Mailing Address April 27, 2017

Registered at 104 ASHLAND AVENUE, MT. ZION, IL 62549 (Tel: 2178642665)

👤

Provider Name / Credentials Updated April 27, 2017

Recorded as KELSEY THACKER

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2017

Nurse Practitioner (License #209015926 in IL)

🟢

Initial NPI Registration & Enumeration April 27, 2017

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: 1245765296

Entity Type:

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

Enumeration Date: April 27, 2017

Last Update: April 27, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

104 Ashland Avenue

Mt. Zion, IL 62549

Phone: 2178642665

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

⚠️ Medical Disclaimer

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