Individual provider Active NPI

Theodore J. Gleason, M.D.

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1295848216
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36082552 Issued in IL
Practice address
800 E Carpenter St
Department of Radiology
Springfield, IL 62702-5324
Phone
(217) 544-6464
Fax
(217) 525-5671
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 36082552 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Department of Radiology
Springfield, IL 62702-5324

Mailing address

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

Other identifiers 2

IdentifierTypeStateIssuer
300026084OtherILRR MEDICARE
P00028344OtherILRR MEDICARE

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
I20050928000679 IL Practitioner - Diagnostic Radiology 8729013891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rush Medical College of Rush University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Practice addresses (Care Compare)

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

1215 Franciscan Dr
Litchfield, IL 62056-1778
Phone (217) 324-2191

12866 Troxler Ave
Highland, IL 62249-2806
Phone (309) 740-4272

1512 N Green Mount Rd
O Fallon, IL 62269-2083
Phone (618) 234-2120

1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (309) 740-4272

200 Health Care Dr
Greenville, IL 62246-1154
Phone (309) 740-4272

200 S Cedar St
Shelbyville, IL 62565-1838
Phone (217) 774-3961

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522

400 N 9TH St
Springfield, IL 62702-5310
Phone (217) 544-6464

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 342-2121

5200 Reliable Pkwy
Chicago, IL 60686-0052

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272

530 Neglen Oak Ave
Peoria, IL 61636-0001
Phone (309) 655-2000

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

818 E Broadway St
Sparta, IL 62286-1820
Phone (618) 443-2177

9515 Holy Cross LN
Breese, IL 62230-3618
Phone (309) 740-4272

Hospital & facility affiliations

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • Anderson Hospital Hospital, Maryville, IL, CCN 140289
  • St Josephs Hospital Hospital, Breese, IL, CCN 140145
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maryville Imaging, LLC CurrentSince Dec 23, 2025 Accepting new patients
Maryville Imaging, LLC CurrentSince Dec 23, 2025 Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Feb 1, 2010 Accepting new patients
Cira Michigan PC Diagnostic Radiology Past Accepting new patients
Springfield Radiologists SC Diagnostic Radiology Past Accepting new patients

Locations

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

1215 Franciscan Dr
Litchfield, IL 62056
Phone (217) 324-2191

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054

111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144

319 E Madison St
Springfield, IL 62701
Phone (217) 545-7627

800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1295848216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025324",
            "telephone_number": "217-544-6464",
            "fax_number": "217-525-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "THEODORE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "36082552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300026084",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00028344",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.