Individual provider Active NPI

Connie Leanne Robinson, P.A.

  • Medical Physician Assistant
  • Springfield, IL
National Provider Identifier
1316021793
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-002129 Issued in IL
Practice address
619 E Mason St
Suite 4P57
Springfield, IL 62701-1034
Phone
(217) 788-0706
Fax
(217) 525-2535
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-002129 IL Primary
Cardiovascular Disease Physician 207RC0000X 085.002129 IL

Addresses

Primary practice location

619 E Mason St
Suite 4P57
Springfield, IL 62701-1034

Mailing address

619 E Mason St Ste 4P57
Springfield, IL 62701-1034
Phone (217) 788-0706

Other names 1

  • Connie Leanne Berry Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crobinson100126@ewd.direct.hshs.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040108000112 IL Practitioner - Physician Assistant 5799684726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 E Mason St
Springfield, IL 62701-1034
Phone (217) 788-0706

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.002129ILMDCardiovascular Disease Physician
085-002129ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Cardiovascular Consultants LTD Cardiovascular Disease Past Accepting new patients

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.

Hospital & facility affiliations 1

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1316021793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E MASON ST STE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST",
            "address_2": "SUITE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "CONNIE",
        "middle_name": "LEANNE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-002129",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "085.002129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crobinson100126@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "619 E Mason St",
            "address_2": "Suite 4P57",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "BERRY",
            "middle_name": "LEANNE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.