NPIMap

Individual provider Active NPI

Cara E Vasconcelles, M.D.

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1114992658
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036087654 Issued in IL
Practice address
3132 Old Jacksonville Rd
Suite 200
Springfield, IL 62704-7400
Phone
(217) 862-0804
Fax
(217) 862-0871
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036087654 IL
Pediatrics Physician 208000000X 036087654 IL Primary

Addresses

Primary practice location

3132 Old Jacksonville Rd
Suite 200
Springfield, IL 62704-7400

Mailing address

3132 Old Jacksonville Rd
Suite 200
Springfield, IL 62704-7400
Phone (217) 862-0804

Other identifiers 1

IdentifierTypeStateIssuer
036087654MedicaidIL

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
I20090313000166 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8921164195

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Southern Illinois University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Springfield, IL 62708

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036087654ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services Current Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Memorial Physician Services Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients
Memorial Physician Services CurrentSince Jan 1, 2013 Accepting new patients
Memorial Health Partners Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Memorial Expresscare, LLC Internal Medicine Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

3132 Old Jacksonville Rd
Ste 200
Springfield, IL 62704
Phone (217) 862-0800

Interoperability endpoints

  • Direct secure messaging: caravasconcelles@sfc.allscriptsdirect.net
  • Direct secure messaging: caravasconcelles@memorial.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1114992658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047400",
            "telephone_number": "217-862-0804",
            "fax_number": "217-862-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047400",
            "telephone_number": "217-862-0804",
            "fax_number": "217-862-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASCONCELLES",
        "first_name": "CARA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036087654",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036087654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087654",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.