Individual provider Active NPI

Tina M. Umberger, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1326036302
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209003783 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2403
Phone
(217) 528-7541
Fax
(217) 527-8956
NPI assigned
Oct 12, 2005
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 041265469 IL
Certified Registered Nurse Anesthetist 367500000X 209003783 IL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2403

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other practice location 1

800 East Carpenter Street
Room 2K64
Springfield, IL 62769-0001
Phone (217) 525-5643

Other identifiers 2

IdentifierTypeStateIssuer
52332OtherILAANA#
041265469OtherILIL LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000495 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224206677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041265469ILMDCertified Registered Nurse Anesthetist
209003783ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Jul 15, 2022 Accepting new patients
Springfield Clinic, LLP CurrentSince Sep 11, 2017 Accepting new patients
Sangamon Associated Anesthesiologists, S.C. Past Accepting new patients
Memorial Medical Center Past Accepting new patients
Sangamon Associated Anesthesiologists, S.C. Nurse Anesthetist, Certified Registered PastSince Jun 27, 2011 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

7309 N Knoxville Ave
Peoria, IL 61614
Phone (309) 282-0827

1025 S 6th St
Springfield, IL 62703

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

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

800 E Carpenter St
Rm 2334
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Rm 2K64
Springfield, IL 62702

800 E Carpenter St
Rm 2K64
Springfield, IL 62769
Phone (217) 525-5643

Interoperability endpoints

  • Direct secure messaging: tina.umberger.1@28977.direct.athenahealth.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1326036302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541",
            "fax_number": "217-527-8956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 East Carpenter Street",
            "address_2": "Room 2K64",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627690001",
            "country_code": "US",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UMBERGER",
        "first_name": "TINA",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041265469",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209003783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA#",
            "identifier": "52332",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE #",
            "identifier": "041265469",
            "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 Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.