Active NPI 1245328574 Individual Practitioner Female Practitioner

Dr. Denise A Mcguffin , MD

Internal Medicine • Normal, IL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Denise Mcguffin, MD is a certified Internal Medicine practicing in Normal, IL. With approximately 24 years of clinical experience since graduating from Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University in 2002, Dr. Mcguffin delivers high-quality medical care to the local community at 1304 FRANKLIN AVE.

Dr. Mcguffin maintains professional affiliations with Carle West Physician Group Inc, Carle Health Care Incorporated and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, hospital discharge day management, more than, follow-up hospital inpatient care per day. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1304 Franklin Ave

Normal, IL 617613558

Telephone 3094541400

Associated Practice Facility / Clinic

🏢 Carle Bromenn Medical Center Facility NPI 1962489815

Medicare Profile & Education

Medical School

Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Normal, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

24 Yrs +8.1 yrs vs City Avg

City Avg: 15.9 Yrs

State Avg: 28.9 Yrs

Regional Practice Density

16 Specialists

Practicing in Normal, IL (7544 Statewide)

Telehealth Adoption Rate

12.5% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

67.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mcguffin (24 Years) 24 Yrs

Normal Specialty Average (15.9 Years) 15.9 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
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	498	208	$215.30	$75.68
99239 Hospital discharge day management, more than 30 minutes	135	131	$320.00	$109.67
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	119	72	$315.00	$113.66
99231 Follow-up hospital inpatient care per day, typically 15 minutes	49	40	$125.00	$46.39
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	20	$405.00	$126.31
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	16	$590.00	$167.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	479	201	$205.61	$77.34
99239 Hospital discharge day management, more than 30 minutes	116	114	$305.00	$109.99
99231 Follow-up hospital inpatient care per day, typically 15 minutes	93	53	$115.00	$48.88
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	92	53	$300.00	$116.30
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	37	37	$389.86	$127.58
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	34	16	$255.00	$102.91
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	33	33	$560.00	$169.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	613	227	$200.18	$69.36
99239 Hospital discharge day management, more than 30 minutes	108	104	$295.00	$101.84
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	104	65	$290.00	$99.98
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	55	25	$245.00	$87.05
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	30	29	$375.00	$131.84
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	24	$540.00	$193.62
99225 Subsequent observation care, typically 25 minutes per day	23	14	$200.00	$69.29
99217 Hospital observation care on day of discharge	19	19	$200.00	$69.66
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	13	$350.00	$123.73
99316 Nursing facility discharge management, more than 30 minutes	12	11	$290.00	$99.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	337	137	$256.64	$104.03
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	163	81	$187.71	$69.99
99239 Hospital discharge day management, more than 30 minutes	118	116	$258.52	$107.02
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	53	51	$476.15	$205.38
99217 Hospital observation care on day of discharge	26	26	$179.85	$70.19
99291 Critical care, first 30-74 minutes	22	13	$714.27	$221.59
99220 Hospital observation care, typically 70 minutes	17	17	$417.65	$183.34
99226 Subsequent observation care, typically 35 minutes per day	16	15	$250.00	$105.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	363	128	$241.00	$110.00
99239 Hospital discharge day management, more than 30 minutes	99	95	$241.00	$114.35
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	61	59	$437.00	$217.44
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	36	21	$168.00	$77.16
99217 Hospital observation care on day of discharge	25	25	$166.00	$77.82
99220 Hospital observation care, typically 70 minutes	15	15	$400.00	$199.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	255	115	$237.67	$111.02
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	126	65	$163.24	$77.75
99239 Hospital discharge day management, more than 30 minutes	114	106	$241.00	$113.82
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	72	68	$425.97	$216.31
99217 Hospital observation care on day of discharge	35	33	$166.00	$77.91
99219 Hospital observation care, typically 50 minutes	12	12	$252.00	$145.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	230	96	$227.32	$110.29
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	135	71	$154.86	$77.34
99239 Hospital discharge day management, more than 30 minutes	107	97	$218.79	$113.77
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	88	82	$405.28	$214.10
99217 Hospital observation care on day of discharge	22	22	$150.32	$77.59
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	20	$280.70	$146.04
99219 Hospital observation care, typically 50 minutes	13	13	$242.77	$144.75
99220 Hospital observation care, typically 70 minutes	11	11	$322.09	$197.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	174	85	$150.00	$76.45
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	138	67	$220.00	$106.41
99239 Hospital discharge day management, more than 30 minutes	87	83	$205.00	$112.39
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	44	42	$385.00	$212.26
99219 Hospital observation care, typically 50 minutes	26	26	$240.00	$144.36
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	23	$273.00	$146.42
99217 Hospital observation care on day of discharge	19	19	$143.00	$77.25

Medical Specialties & State Licenses

CMS Verified: 2021-10-06

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IL 036114173

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036114173 (IL)

Hospital & Practice Group Affiliations

Carle West Physician Group Inc

2204 Eastland Dr, Bloomington, IL 617043567

Phone: 3096630222

Carle Health Care Incorporated

611 W Park St, Urbana, IL 618012501

Carle Health Care Incorporated

611 W Park St, Urbana, IL 618012501

Phone: 8887122753

Carle Health Care Incorporated

611 W Park St, Urbana, IL 618012500

Carle West Physician Group Inc

101 S Major St, Eureka, IL 615301246

Phone: 3093042128

Carle Health Care Incorporated

101 S Major St, Eureka, IL 615301246

Phone: 3093042128

Practice Associates & Co-Workers

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

38 Associated Practitioners

Dr. Julie Lewis , MD

Emergency Medicine

NPI 1013068667

Doctor of Medicine (M.D.)

Elizabeth Madlem , APRN, CNP

Nurse Practitioner - Family

NPI 1033543822

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Ann Schoen , CRNA

Nurse Practitioner - Psychiatric/Mental Health

NPI 1043551856

Certified Registered Nurse Anesthetist

Dr. Stephanie Sullivan , MD

Emergency Medicine

NPI 1073952396

Doctor of Medicine (M.D.)

Dodi Suhari , CRNA

Nurse Anesthetist, Certified Registered

NPI 1083043483

Certified Registered Nurse Anesthetist

Dr. Nicholas Florence , MD

Radiology - Diagnostic Radiology

NPI 1093100554

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location October 27, 2021

Registered at 1304 FRANKLIN AVE, NORMAL, IL 617613558 (Tel: 3094541400)

📍

Updated Business Mailing Address October 27, 2021

Registered at 611 W. PARK ST, FAPC, URBANA, IL 61801

✅

NPI Profile Active May 08, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location May 08, 2009

Registered at 5037 KELVINDALE RD, #A, LOVES PARK, IL 611111550 (Tel: 8156330275)

📍

Updated Business Mailing Address May 08, 2009

Registered at 5037 KELVINDALE RD, #A, LOVES PARK, IL 611111550 (Tel: 8156330275)

👤

Provider Name / Credentials Updated May 08, 2009

Recorded as DENISE MCGUFFIN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 08, 2009

Internal Medicine (License #036114173 in IL)

🟢

Initial NPI Registration & Enumeration October 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1245328574

Entity Type:

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

Enumeration Date: October 11, 2006

Last Update: October 27, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

611 W. Park St, Fapc

Urbana, IL 61801

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.