Individual provider Active NPI

Kelly Galanos, M.D.

  • Emergency Medicine Physician
  • Springfield, IL
National Provider Identifier
1043627219
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125-066050 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62702-3757
Phone
(217) 545-3518
Fax
(217) 545-2711
NPI assigned
Jul 19, 2014
Last updated
Mar 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125-066050 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62702-3757

Mailing address

PO Box 19638
Springfield, IL 62794-9638
Phone (217) 545-3518

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
I20170913000751 IL Practitioner - Emergency Medicine 7810295524 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Southern Illinois University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Passavant Memorial Area Hospital AssociationGroup PAC ID 3173503281, shared by 2 NPIs, 9 clinicians
Midwest Emergency Department Specialists LTDGroup PAC ID 5193627727, 62 clinicians

Practice addresses (Care Compare)

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone 21724595415652

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-066050ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Passavant Memorial Area Hospital Association CurrentSince Dec 24, 2025 Accepting new patients
Passavant Memorial Area Hospital Association CurrentSince Nov 1, 2023 Accepting new patients
Midwest Emergency Department Specialists LTD Emergency Medicine CurrentSince Aug 10, 2017 Accepting new patients
Passavant Memorial Area Hospital Association Current Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Organizations & group practices 4

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 2

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": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1043627219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19638",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949638",
            "telephone_number": "217-545-3518",
            "fax_number": "217-545-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023757",
            "telephone_number": "217-545-3518",
            "fax_number": "217-545-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALANOS",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-066050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.