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Active NPI 1457704025 Individual Practitioner Female Practitioner

Kathy Jean Stark , AGPCNP-BC

Nurse Practitioner - Gerontology • Springfield, IL

Professional Overview & Biography Verified Profile Summary

Kathy Stark, AGPCNP-BC is a registered healthcare professional specializing in Nurse Practitioner - Gerontology in Springfield, IL. Practice services are available at 747 N RUTLEDGE ST under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

747 N Rutledge St
5th Floor

Springfield, IL 627026700

Telephone 2175458000
Fax 2175457063
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Gerontology in Springfield, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
15 Specialists

Practicing in Springfield, IL (294 Statewide)

Telehealth Adoption Rate
6.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
45.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
35 30 $81.00 $46.87
99213 Established patient office or other outpatient visit, typically 15 minutes
12 12 $143.00 $75.61

Medical Specialties & State Licenses

CMS Verified: 2020-12-07
Nurse Practitioner - Gerontology Primary Specialty

NUCC Taxonomy Code: 363LG0600X

State License IL 209014267

Definition to come...

Nurse Practitioner - Adult Health

NUCC Taxonomy Code: 363LA2200X

State License IL 209014267

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
209014267 (IL)

Practice Associates & Co-Workers

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

40 Associated Practitioners
Amanda Henson , LCSW

Social Worker - Clinical

NPI 1003247115

Licensed Clinical Social Worker

Dr. Fadel Bofarrag , MD, MPH

Internal Medicine - Cardiovascular Disease

NPI 1003291279

Doctor of Medicine (M.D.), Master of Public Health

Jerry Priddy , PA-C

Physician Assistant

NPI 1003351115

Physician Assistant (Certified)

Dr. Ashley Mohan , DO

Internal Medicine - Hematology & Oncology

NPI 1003377565

Doctor of Osteopathic Medicine (D.O.)

Dr. Linda Ponce Rosas , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1003501065

Doctor of Medicine (M.D.)

Jay Benoit

Nurse Practitioner - Family

NPI 1003579335

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active November 14, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 14, 2016

Registered at 747 N RUTLEDGE ST, 5TH FLOOR, SPRINGFIELD, IL 627026700 (Tel: 2175458000)

📍
Updated Business Mailing Address November 14, 2016

Registered at 747 N RUTLEDGE ST, PO BOX 19627, SPRINGFIELD, IL 627026700 (Tel: 2175458000)

👤
Provider Name / Credentials Updated November 14, 2016

Recorded as KATHY STARK, AGPCNP-BC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2016

Nurse Practitioner (License #209014267 in IL)

🟢
Initial NPI Registration & Enumeration July 19, 2016

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: 1457704025
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2016
Last Update: December 07, 2020
Sole Proprietor: No

Mailing Address

747 N Rutledge St, Po Box 19627

Springfield, IL 627026700

Phone: 2175458000

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.