Individual provider Active NPI

Rucha Haily Dalvi, M.D.

  • Child & Adolescent Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1336692367
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036.152943 Issued in IL
Practice address
319 E Madison St FL 3
Springfield, IL 62701-1035
Phone
(217) 545-8000
Fax
(217) 545-9537
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125068426 IL
Child & Adolescent Psychiatry Physician 2084P0804X 036.152943 IL Primary

Addresses

Primary practice location

319 E Madison St FL 3
Springfield, IL 62701-1035

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

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
I20220621001770 IL Practitioner - Psychiatry 7315232030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

319 E Madison St
FL 3
Springfield, IL 62701-1035
Phone (217) 545-8000

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

State licenses

LicenseStateTypeSpecialty
125068426ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 1, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 1, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 1, 2022 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

901 W Jefferson St
Springfield, IL 62702
Phone (217) 545-8229

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

319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627

201 E Madison St
Ste 328
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: ruchadalvi@siusm.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1336692367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E MADISON ST FL 3",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011035",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALVI",
        "first_name": "RUCHA",
        "middle_name": "HAILY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125068426",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.152943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.