NPIMap

Board of Trustees of Southern Illinois University

A Medicare group practice based in Springfield, IL: 20 NPIs enrolled under one PECOS associate control ID (PAC ID 4486667888), with 289 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
4486667888The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
Enrolled in
IL
Enrollments
19
Group size
139 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
36In 8 places

Enrollment records 19

Enrollment IDStateProvider typeNPI
O20160725001980 IL Part A Provider - Federally Qualified Health Center (FQHC) 1649628009
O20170316002207 IL Part A Provider - Federally Qualified Health Center (FQHC) 1972049641
O20170717002084 IL Part A Provider - Federally Qualified Health Center (FQHC) 1407376338
O20180403002167 IL Part A Provider - Federally Qualified Health Center (FQHC) 1003324260
O20180108000281 IL Part A Provider - Federally Qualified Health Center (FQHC) 1821511783
O20130424001019 IL Part B Supplier - Clinic/Group Practice 1396097960
O20150831000048 IL Part A Provider - Federally Qualified Health Center (FQHC) 1376921924
O20121002000020 IL Part A Provider - Federally Qualified Health Center (FQHC) 1497002182
O20230221002665 IL Part A Provider - Federally Qualified Health Center (FQHC) 1205553195
O20230414000368 IL Part A Provider - Federally Qualified Health Center (FQHC) 1558848473
O20240716001838 IL Part A Provider - Federally Qualified Health Center (FQHC) 1568210425
O20240404002213 IL Part A Provider - Federally Qualified Health Center (FQHC) 1184494619
O20191008000423 IL Part A Provider - Federally Qualified Health Center (FQHC) 1437708674
O20200930002015 IL Part A Provider - Federally Qualified Health Center (FQHC) 1619501871
O20210903000716 IL Part A Provider - Federally Qualified Health Center (FQHC) 1679188437
O20211216000311 IL Part A Provider - Federally Qualified Health Center (FQHC) 1770259764
O20220414001368 IL Part A Provider - Federally Qualified Health Center (FQHC) 1598412447
O20200309002148 IL Part A Provider - Federally Qualified Health Center (FQHC) 1851934871
O20221104000252 IL Part A Provider - Federally Qualified Health Center (FQHC) 1558099523

NPIs in this group 20

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 289

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Clinicians who reassign their Medicare benefits to this group (288) or whom Care Compare lists as members (139).

Sources for this page