Individual provider Active NPI

Sara Beth Rubenacker, M.D.

  • Obstetrics & Gynecology Physician
  • Springfield, IL
National Provider Identifier
1023304094
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
125.059927 Issued in IL
Practice address
415 N 9TH St
Springfield, IL 62702-5303
Phone
(217) 545-5117
Fax
(217) 545-4912
NPI assigned
Jun 28, 2011
Last updated
Jun 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125.059927 IL Primary

Addresses

Primary practice location

415 N 9TH St
Springfield, IL 62702-5303

Mailing address

PO Box 19640
Springfield, IL 62794-9640
Phone (217) 545-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150826001280 IL Practitioner - Obstetrics/Gynecology 8224344957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Southern Illinois University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Women's Healthcare LTDGroup PAC ID 1759270648, 29 clinicians

Practice addresses (Care Compare)

3408 Office Park Dr
Marion, IL 62959-6477
Phone (618) 997-5266

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.059927ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Women's Healthcare LTD CurrentSince Aug 3, 2015 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. Obstetrics & Gynecology CurrentSince Nov 1, 2015 Accepting new patients
Heartland Women's Healthcare LTD Obstetrics & Gynecology Current Accepting new patients

Locations

900 E Walnut St
Ste 10
Carbondale, IL 62901

811 Fairfax St
Carlyle, IL 62231
Phone (618) 594-3025

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

929 Stacey Burk Dr
Flora, IL 62839

3408 Office Park Dr
Marion, IL 62959
Phone (318) 997-5266

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

3130 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (708) 736-1727

3230 Veterans Memorial Dr
Mount Vernon, IL 62864

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

1170 Fortune Blvd
Shiloh, IL 62269
Phone (844) 872-6249

6 Park Pl
Swansea, IL 62226
Phone (618) 233-0522

Interoperability endpoints

  • Direct secure messaging: sara.rubenacker.1@21608.direct.athenahealth.com
  • Direct secure messaging: srubenacker149121@direct-ehr-ssmhc.com

Organizations & group practices 3

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1023304094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19640",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949640",
            "telephone_number": "217-545-5117",
            "fax_number": "217-545-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-5117",
            "fax_number": "217-545-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENACKER",
        "first_name": "SARA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125.059927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.