Active NPI
Jamie L Wasilewski, PHD
- Clinical Psychologist
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.010808
- Practice address
- 319 E Madison St FL 3
Springfield, IL 62701-1035 - Phone
- (217) 545-8000
- NPI assigned
- Sep 7, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1535 | OR | |
| Clinical Psychologist | 103TC0700X | 071.010808 | IL | Primary |
Addresses
Primary practice location
319 E Madison St FL 3
Springfield, IL 62701-1035
Mailing address
201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000
Other practice location 1
Madigan Army Medical Center 9040 Jackson Avenue
Tacoma, WA 98431-2109
Phone (253) 968-9047
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
319 E Madison St
FL 3
Springfield, IL 62701-1035
Phone (217) 545-8000
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1535 | OR | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients |
Locations
319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627
201 E Madison St
Ste 328
Springfield, IL 62702
751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182
Interoperability endpoints
- jamiewasilewski@siusm.allscriptsdirect.net
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 and National Provider Directory roles.
-
- Endocrinology, Diabetes & Metabolism Physician
- Springfield, IL
- NPI 1558385989
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Durable Medical Equipment & Medical Supplies
- Springfield, IL
- NPI 1164055976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1083717490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E MADISON ST STE 328",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025131",
"telephone_number": "217-545-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 E MADISON ST FL 3",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011035",
"telephone_number": "217-545-8000"
}
],
"practiceLocations": [
{
"address_1": "Madigan Army Medical Center 9040 Jackson Avenue",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984312109",
"country_code": "US",
"telephone_number": "253-968-9047",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WASILEWSKI",
"first_name": "JAMIE",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "1535",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.010808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Aug 11, 2022; 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.