Individual provider Active NPI

Poornima Jayaramaiah, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
National Provider Identifier
1174784086
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036-120847 Issued in IL
Practice address
1118 W Legacy Pointe Dr
Springfield, IL 62711-6444
Phone
(217) 787-8870
Fax
(217) 787-6158
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036-120847 IL Primary

Addresses

Primary practice location

1118 W Legacy Pointe Dr
Springfield, IL 62711-6444

Mailing address

1118 W Legacy Pointe Dr
Springfield, IL 62711-6444
Phone (217) 787-8870

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pjayaramaiah104712@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: 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
I20110225000130 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 4284815176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1118 W Legacy Pointe Dr
Springfield, IL 62711-6444
Phone (217) 787-8870

176 W Mound Rd
Decatur, IL 62526-1964
Phone (217) 391-8730

1836 S Macarthur Blvd
Springfield, IL 62704-4030
Phone (217) 789-1403

1900 E Lake Shore Dr
Suite 330
Decatur, IL 62521-3848
Phone (217) 423-2889

4965 E Lost Bridge Rd
Decatur, IL 62521-5139
Phone (217) 864-5531

Hospital & facility affiliations

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352
  • Pana Community Hospital Hospital, Pana, IL, CCN 141341
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166
  • St Francis Hospital Hospital, Litchfield, IL, CCN 141350

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-120847ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Oct 6, 2010 Accepting new patients
HSHS Medical Group Inc CurrentSince Oct 6, 2010 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

2501 Chatham Rd
Ste 300
Springfield, IL 62704
Phone (217) 787-8870

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

1118 W Legacy Pointe Dr
Springfield, IL 62711
Phone (217) 528-3233

Interoperability endpoints

  • Direct secure messaging: pjayaramaiah104712@ewd.direct.hshs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1174784086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 W LEGACY POINTE DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116444",
            "telephone_number": "217-787-8870",
            "fax_number": "217-787-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 W LEGACY POINTE DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116444",
            "telephone_number": "217-787-8870",
            "fax_number": "217-787-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYARAMAIAH",
        "first_name": "POORNIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036-120847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjayaramaiah104712@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1118 W Legacy Pointe Dr",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627116444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.