Active NPI
Ronald R Romanelli, MD
- Orthopaedic Surgery Physician
- Springfield, IL
National Provider Identifier
1295714244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 036069839
- Practice address
- 1301 S Koke Mill Rd
Springfield, IL 62711-9252 - Phone
- (217) 547-9100
- Fax
- (217) 547-9247
- NPI assigned
- Jan 10, 2006
- Reactivated
- Jun 9, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 036069839 | IL | Primary |
Addresses
Primary practice location
1301 S Koke Mill Rd
Springfield, IL 62711-9252
Mailing address
PO Box 9469
Springfield, IL 62791-9469
Phone (217) 547-9100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036069839 | Medicaid | IL | |
| 200026706 | Other | IL | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036069839 | IL | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Center of Illinois | Past | Accepting new patients | |
| Open MRI of Jacksonville LLC | Past | Accepting new patients |
Interoperability endpoints
- rrr001@oci2123.srs-direct.com
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.
-
- Body Imaging Physician
- Jacksonville, IL
- NPI 1760527873
-
- Durable Medical Equipment & Medical Supplies
- Springfield, IL
- NPI 1144372798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1295714244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9469",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627919469",
"telephone_number": "217-547-9100",
"fax_number": "217-547-9247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 S KOKE MILL RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627119252",
"telephone_number": "217-547-9100",
"fax_number": "217-547-9247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMANELLI",
"first_name": "RONALD",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"deactivation_date": "2020-04-06",
"reactivation_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "036069839",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036069839",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "200026706",
"state": "IL"
}
],
"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 Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.