Doctor profile · Federal record

Dr. Jack Capodice, MD, DMD

Oral and Maxillofacial Surgery (Dentist) (CMS: Oral Surgery) · Bloomington, IL

  • NPI 1053397612
  • Accepts Medicare
  • 36 yrs in practice
  • Male
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
109 N Regency Dr
Bloomington, IL 617013515
(309) 663-2526
fax (309) 663-4788

Credentials & registration

NPPES · NUCC
NPI registered
December 2005 — 21 yrs on file
Profile last updated
April 6, 2026
Year of graduation
1990 — 36 yrs since
Specialty taxonomy
1223S0112X — NUCC code
State license (1)
Illinois #019022744

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1053397612. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
22
Distinct HCPCS
1
Medicare allowed
$1,524
HCPCS Description Services Patients Avg allowed
99202 New patient office or other outpatient visit, 15-29 minutes 22 22 $69

In context: peer comparison

Among 3 peers in this city , average services per provider: 20. This provider delivers 1.1× the peer median.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$233
Transactions
9
Manufacturers
2
Payer (manufacturer) Industry Txns Amount
BioHorizons Implant Systems Inc. 7 $187.50
ZIMVIE INC. 2 $45.92

By nature of payment

Food and Beverage
$233

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
885
Patients
667
Total drug cost
$5,660
Drug Type Claims Patients Total cost
Chlorhexidine Gluconate Generic 305 147 $1,644
Penicillin V Potassium Generic 173 162 $909
Hydrocodone-Acetaminophen (Hydrocodone/Acetaminophen) Brand 131 124 $236
Clindamycin Hcl Generic 91 77 $485
Amoxicillin Generic 75 70 $307
Tramadol Hcl Generic 43 39 $59
Azithromycin Generic 29 24 $162
Amoxicillin-Clavulanate Potass (Amoxicillin/Potassium Clav) Brand 24 24 $188
Doxycycline Hyclate Generic 14 0 $1,669

Frequently asked questions

Auto-generated from federal data
What is Dr. Jack Capodice's medical specialty?
Dr. Jack Capodice practices Oral and Maxillofacial Surgery (Dentist) in Bloomington, IL.
Where does Dr. Jack Capodice practice?
Dr. Jack Capodice practices at 109 N Regency Dr, Bloomington, IL 617013515. Office phone: 3096632526.
What is Dr. Jack Capodice's NPI?
Dr. Jack Capodice's National Provider Identifier (NPI) is 1053397612, issued by NPPES.
Does Dr. Jack Capodice accept Medicare assignment?
Yes. Dr. Jack Capodice accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Jack Capodice commonly perform?
Top Medicare-reported procedures in 2023: New patient office or other outpatient visit (HCPCS 99202). Source: CMS Medicare Physician & Other Practitioners file.