Active NPI
Marisa Blitstein, M.D.
- Diagnostic Radiology Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036135461
- Practice address
- 701 N 1St St
Springfield, IL 62781-0001 - Phone
- (217) 726-3389
- NPI assigned
- Oct 23, 2007
- Last updated
- Nov 9, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036135461 | IL | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 2014022413 | MO |
Addresses
Primary practice location
701 N 1St St
Springfield, IL 62781-0001
Mailing address
3050 Montvale Dr
Springfield, IL 62704-4290
Phone (217) 726-3389
Other practice location 1
2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-0690
Other practice location 2
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-0690
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
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Warren Alpert Medical School of Brown University, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 W Morton Ave
Jacksonville, IL 62650-3152
Phone (217) 243-6520
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
1600 W Walnut St
Jacksonville, IL 62650-1136
Phone (217) 245-9541
200 Stahlhut Dr 1St Floor Room
Suite 428
Lincoln, IL 62656-5066
Phone (217) 605-5309
201 E Pleasant St
Taylorville, IL 62568-1562
Phone (217) 824-3566
2200 Wabash Ave
Springfield, IL 62704-5352
Phone (217) 787-0727
350 W Carpenter St
Springfield, IL 62702-4902
Phone (217) 525-0210
400 Saint Johns Dr
Sherman, IL 62684-9779
Phone (217) 525-4150
4525 Wabash Ave
Springfield, IL 62711-7038
Phone (217) 528-7541
600 N Main St
Taylorville, IL 62568-1668
Phone (217) 824-8191
701 N 1St St
Springfield, IL 62781-0001
Phone (217) 528-7541
775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300
800 N 1St St
Springfield, IL 62702-3719
Phone (217) 528-7541
Hospital & facility affiliations
- Memorial Medical Center
- Abraham Lincoln Memorial Hospital
- Taylorville Memorial Hospital
- Jacksonville Memorial Hospital
- St Johns Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 75.65
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036135461 | IL | MD | Diagnostic Radiology Physician |
| 2014022413 | MO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic, LLP | Current | Accepting new patients | |
| Crawford Hospital District | Current | Accepting new patients | |
| Memorial Medical Center | Past | Accepting new patients | |
| Clinical Radiologists, S.C. | Diagnostic Radiology | Past | Accepting new patients |
| Clinical Radiologists, S.C. | Diagnostic Radiology | Past | Accepting new patients |
Locations
1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131
1025 S 6th St
Springfield, IL 62703
701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100
775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300
Interoperability endpoints
- marisa.blitstein.1@28977.direct.athenahealth.com
Ownership & related parties
All facility ownership & control disclosures 5
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Springfield Clinic Lincoln Rural Health | Rural health clinic | Limited Partnership Interest | Jul 1, 2021 |
| Springfield Clinic Nokomis Rural Health | Rural health clinic | Limited Partnership Interest | Jul 1, 2021 |
| Springfield Clinic Raymond Rural Health | Rural health clinic | Limited Partnership Interest | Jul 1, 2021 |
| Springfield Clinic Neoga Rural Health | Rural health clinic | Limited Partnership Interest | Jul 1, 2021 |
| Springfield Clinic, LLP | Rural health clinic | Limited Partnership Interest | Jul 1, 2021 |
Owned or controlled facilities with NPI records 5
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Raymond, IL
- NPI 1013255942
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Macomb, IL
- NPI 1730831157
Limited Partnership Interest
-
dba Springfield Clinic Rural Health Neoga
- Rural Health Clinic/Center
- Neoga, IL
- NPI 1972790889
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Lincoln, IL
- NPI 1518143452
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Nokomis, IL
- NPI 1922285600
Limited Partnership Interest
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1780638478
-
dba Crawford Memorial Hospital
- Internal Medicine Physician
- Robinson, IL
- NPI 1861423287
-
- Diagnostic Radiology Physician
- Edwardsville, IL
- NPI 1700219482
-
dba The Hearing Center at Memorial
- Audiologist
- Springfield, IL
- NPI 1679549968
-
- Diagnostic Radiology Physician
- Boulder, CO
- NPI 1992114714
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Lincoln, IL
- NPI 1154329753
-
- General Acute Care Hospital
- Springfield, IL
- NPI 1255317590
-
dba Passavant Area Hospital
- Critical Access Hospital
- Jacksonville, IL
- NPI 1174580831
-
dba HSHS St. John's Hospital
- General Acute Care Hospital
- Springfield, IL
- NPI 1205818481
-
- Critical Access Hospital
- Taylorville, IL
- NPI 1144292020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1194914465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 MONTVALE DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627044290",
"telephone_number": "217-726-3389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N 1ST ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627810001",
"telephone_number": "217-726-3389"
}
],
"practiceLocations": [
{
"address_1": "2301 Holmes St",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082640",
"country_code": "US",
"telephone_number": "816-404-0690",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7900 Lees Summit Rd",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641391236",
"country_code": "US",
"telephone_number": "816-404-0690",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLITSTEIN",
"first_name": "MARISA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-23",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036135461",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2014022413",
"primary": false
}
],
"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 Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.