NPIMap

Individual provider Active NPI

Eric Anthony Bloemer, MD

  • Family Medicine Physician
  • Teutopolis, IL
National Provider Identifier
1073742664
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036128692 Issued in IL
Practice address
206 N Pearl St
Teutopolis, IL 62467-1134
Phone
(217) 857-6481
Fax
(217) 857-6094
NPI assigned
Jul 6, 2009
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036128692 IL Primary

Addresses

Primary practice location

206 N Pearl St
Teutopolis, IL 62467-1134

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other practice location 1

601 W Washington St
Newton, IL 62448-1264
Phone (618) 783-0954

Other identifiers 4

IdentifierTypeStateIssuer
036128692OtherILILLINOIS LICENSE
336090050OtherILILLINOIS CONTROLLED SUBSTANCE LICENSE
371391171004MedicaidIL
561920OtherILMEDICARE GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebloemer100808@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120726000235 IL Practitioner - Family Practice 6608068093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

206 N Pearl St
Teutopolis, IL 62467-1134
Phone (217) 528-7541

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 342-2121

600 N Main St
Taylorville, IL 62568-1668
Phone (217) 824-8191

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

801 W Temple Ave
Effingham, IL 62401-2168
Phone (217) 528-7541

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy44
Upper gastrointestinal (GI) endoscopy for acid reflux17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Aug 1, 2013 Accepting new patients
Springfield Clinic, LLP CurrentSince Jul 1, 2022 Accepting new patients
Springfield Clinic LLP Past Accepting new patients

Locations

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

601 W Washington St
Newton, IL 62448
Phone 217528754173331

601 W Washington St
Ste 1
Newton, IL 62448
Phone (217) 347-2707

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

206 N Pearl St
Teutopolis, IL 62467
Phone 217528754173324

Interoperability endpoints

  • Direct secure messaging: eric.bloemer.1@28977.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Anthony's Memorial HospitalEffingham, IL, CCN 140032 Hospital Corporate Director Nov 1, 2022
HSHS Hospice IllinoisEffingham, IL, CCN 141658 Hospice Corporate Director Jun 1, 2022
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Jul 1, 2022
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Jul 1, 2022
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Jul 1, 2022
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Jul 1, 2022
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Jul 1, 2022

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 11

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073742664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N PEARL ST",
            "city": "TEUTOPOLIS",
            "state": "IL",
            "postal_code": "624671134",
            "telephone_number": "217-857-6481",
            "fax_number": "217-857-6094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "IL",
            "postal_code": "624481264",
            "country_code": "US",
            "telephone_number": "618-783-0954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOEMER",
        "first_name": "ERIC",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036128692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "036128692",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS CONTROLLED SUBSTANCE LICENSE",
            "identifier": "336090050",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371391171004",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "561920",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebloemer100808@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "601 W Washington St",
            "city": "Newton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624481264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Teutopolis, IL

Sources for this page

Verify at the official NPI Registry.