Jacob Manoj Kitchener, MD

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

036111221 Issued in IL

Practice address

421 N 9TH St
Springfield, IL 62702

Phone

(217) 757-6868

Fax

(177) 576-8672

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional RadiologyAlso: Neurology

Education

Northeastern Ohio University College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Johns Hospital Hospital, Springfield, IL, CCN 140053
• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
• Blessing Hospital Hospital, Quincy, IL, CCN 140015
• St Francis Hospital Hospital, Litchfield, IL, CCN 141350
• St Marys Hospital Hospital, Decatur, IL, CCN 140166

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.kitchener.1@28977.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment Care Compare group NPD
• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544

  Neurology

  Medicare reassignment Care Compare group NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Premier Health Specialists Inc

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD (past)
• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Blessing Hospital

  • Nurse Practitioner
  • Quincy, IL
  • NPI 1417204827

  Hospital

  Care Compare affiliation
• Blessing Hospital

  • General Acute Care Hospital
  • Quincy, IL
  • NPI 1760571699
  Care Compare affiliation
• St Francis Hospital of the Hospital Sisters of the Third Order of St F

  • Critical Access Hospital
  • Litchfield, IL
  • NPI 1326057076
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation
• St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1326041229
  Care Compare affiliation
• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1003818733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025317",
            "telephone_number": "217-757-6868",
            "fax_number": "177-576-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62702",
            "telephone_number": "217-757-6868",
            "fax_number": "177-576-8672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627011041",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Saint Elizabeth Blvd",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691281",
            "country_code": "US",
            "telephone_number": "618-641-5803",
            "fax_number": "618-607-5116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "One Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-882-1515",
            "fax_number": "573-884-0070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 E Apple St Ste 5254A",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092939",
            "country_code": "US",
            "telephone_number": "937-208-4200",
            "fax_number": "937-208-4205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITCHENER",
        "first_name": "JACOB",
        "middle_name": "MANOJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036111221",
            "primary": true
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OH",
            "license": "35.086697",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2009027338",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036111221",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "35-08-6697-K",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkitchener12121@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jkitchener12121@direct-ehr-ssmhc.com",
            "address_1": "12266 DePaul Dr",
            "address_2": "Suite 100",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR-API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "12266 DePaul Dr",
            "address_2": "Suite 100",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin K Kirkpatrick
• Jonathan R. Kirkwood, MD
• Colleen Kirr, APN
• Julia Kirwan, CCC/SLP/L
• Bridget Lynn Kistner, MD
• Joshua Kleczynski
• Kirk Klein, PHARMD
• Susan Valerie Klein
• Tammie A. Klein, M.D.
• Caitlyn Kleiss

• Vascular Neurology Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Vascular Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.