Active NPI
Kaitlyn Elizabeth Engle, MD
- Pediatric Critical Care Medicine Physician
- Springfield, IL
National Provider Identifier
1114556875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 036.165739
- Practice address
- 415 N 9TH St Ste 4W64
Springfield, IL 62702-5303 - Phone
- (217) 545-8000
- Fax
- (217) 757-6654
- NPI assigned
- Apr 5, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036.165739 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Critical Care Medicine Physician | 2080P0203X | 036.165739 | IL | Primary |
Addresses
Primary practice location
415 N 9TH St Ste 4W64
Springfield, IL 62702-5303
Mailing address
PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000
Other practice location 1
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 944-4034
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.165739 | IL | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients |
Locations
415 N 9th St
Ste 4W64
Springfield, IL 62702
751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182
415 N 9th St
Springfield, IL 62702
Phone (217) 545-5117
Organizations & group practices 2
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
-
- 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": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1114556875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19639",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949639",
"telephone_number": "217-545-8000",
"fax_number": "217-545-2101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 N 9TH ST STE 4W64",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025303",
"telephone_number": "217-545-8000",
"fax_number": "217-757-6654"
}
],
"practiceLocations": [
{
"address_1": "705 Riley Hospital Dr",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025109",
"country_code": "US",
"telephone_number": "317-944-4034",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENGLE",
"first_name": "KAITLYN",
"middle_name": "ELIZABETH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-05",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.165739",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "IL",
"license": "036.165739",
"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 15, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.