Active NPI
Susan M. O'Neal, D.O.
- Internal Medicine Physician
- Springfield, IL
National Provider Identifier
1003916784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036075503
- Practice address
- 22 Beachview LN
Springfield, IL 62712-9513 - Phone
- (217) 529-2691
- NPI assigned
- Sep 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036075503 | IL | Primary |
| Hospitalist Physician | 208M00000X | 036-075503 | IL |
Addresses
Primary practice location
22 Beachview LN
Springfield, IL 62712-9513
Mailing address
22 Beachview LN
Springfield, IL 62712-9513
Phone (217) 529-2691
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036075503 | Medicaid | IL |
Other names 1
- Susan M. Bettasso
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 75.65
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-075503 | IL | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1003916784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BEACHVIEW LN",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627129513",
"telephone_number": "217-529-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BEACHVIEW LN",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627129513",
"telephone_number": "217-529-2691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEAL",
"first_name": "SUSAN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-23",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036075503",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036-075503",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036075503",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "BETTASSO",
"middle_name": "M.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.