Active NPI
Theodore J. Gleason, M.D.
- Diagnostic Radiology Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 36082552
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300026084 | Other | IL | RR MEDICARE |
| P00028344 | Other | IL | RR 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
Enrollment records 1
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
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
- HSHS St Elizabeth'S Hospital
- Anderson Hospital
- St Josephs Hospital
- St Marys Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryville Imaging, LLC | Current | Accepting new patients | |
| Maryville Imaging, LLC | Current | Accepting new patients | |
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | 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.
-
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
-
- Radiology Clinic/Center
- Edwardsville, IL
- NPI 1831840180
-
- Radiology Clinic/Center
- Maryville, IL
- NPI 1912293002
-
- Diagnostic Radiology Physician
- Springfield, IL
- NPI 1134178502
-
- Diagnostic Radiology Physician
- Escanaba, MI
- NPI 1972141513
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maryville, IL
- NPI 1053481630
-
- General Acute Care Hospital
- O Fallon, IL
- NPI 1629057302
-
- General Acute Care Hospital
- Springfield, IL
- NPI 1205818481
-
- Rural Health Clinic/Center
- Breese, IL
- NPI 1013002658
Hospital
-
- General Acute Care Hospital
- Breese, IL
- NPI 1457319154
-
- General Acute Care Hospital
- Decatur, IL
- NPI 1326041229
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.