Individual provider Active NPI

Tara Z. Bennett, M.D.

  • Obstetrics & Gynecology Physician
  • Springfield, IL
National Provider Identifier
1194713024
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036087658 Issued in IL
Practice address
900 N. 1St Street
Springfield, IL 62702-3749
Phone
(217) 528-7541
Fax
(217) 525-1007
NPI assigned
Oct 13, 2005
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036087658 IL Primary

Addresses

Primary practice location

900 N. 1St Street
Springfield, IL 62702-3749

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
036087658MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tarabennett@sfc.allscriptsdirect.net

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
I20110304000410 IL Practitioner - Obstetrics/Gynecology 0042109456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Southern Illinois University School of Medicine, 1990
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

250 W Kenwood Ave
Decatur, IL 62526-4371
Phone (217) 528-7541

747 N Rutlage Baylis Medical BLD
Suite 50
Springfield, IL 62702-6700
Phone (217) 545-7722

747 N Rutledge St
Springfield, IL 62702-6700
Phone (217) 757-2257

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

900 N 1St St
Springfield, IL 62702-3749
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
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036087658ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Obstetric & Gynecologic Associates, S.C. Obstetrics & Gynecology CurrentSince Aug 1, 1995 Accepting new patients
Springfield Clinic, LLP Obstetrics & Gynecology CurrentSince Mar 1, 2011 Accepting new patients

Locations

1025 S 6th St
Springfield, IL 62703

350 W Carpenter St
Springfield, IL 62702
Phone (217) 525-0210

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

900 N 1st St
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: tara.bennett.1@28977.direct.athenahealth.com
  • Direct secure messaging: tarabennett@sfc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Springfield Memorial HospitalSpringfield, IL, CCN 14S148 Hospital Corporate Director Mar 1, 2025
Springfield Memorial HospitalSpringfield, IL, CCN 14T148 Hospital Corporate Director Mar 1, 2025
Springfield Memorial HospitalSpringfield, IL, CCN 140148 Hospital Corporate Director Mar 1, 2025
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Mar 1, 2011
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Mar 1, 2011
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Mar 1, 2011
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Mar 1, 2011
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Mar 1, 2011

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 2

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 3

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1194713024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N. 1ST STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023749",
            "telephone_number": "217-528-7541",
            "fax_number": "217-525-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TARA",
        "middle_name": "Z.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036087658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087658",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tarabennett@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "900 N. 1st Street",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627023749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.