Individual provider Active NPI

Alessandra Mantovani, MD

  • Neurological Surgery Physician
  • Springfield, IL
National Provider Identifier
1376944025
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036.165800 Issued in IL
Practice address
747 N Rutledge St FL 2
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-9752
NPI assigned
Sep 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X TRN20344 FL
Neurological Surgery Physician 207T00000X F382 CA
Neurological Surgery Physician 207T00000X 036.165800 IL Primary

Addresses

Primary practice location

747 N Rutledge St FL 2
Springfield, IL 62702-6700

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

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
I20230829003867 IL Practitioner - Neurosurgery 0840411203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

747 N Rutledge St
Springfield, IL 62702-6700
Phone (217) 545-8000

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
  • Abraham Lincoln Memorial Hospital Hospital, Lincoln, IL, CCN 141322
  • Pana Community Hospital Hospital, Pana, IL, CCN 141341

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
F382CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 15, 2023 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Stanford Health Care Neurological Surgery Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Aug 15, 2023 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

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

747 N Rutledge St
Springfield, IL 62702
Phone (217) 545-6112

747 N Rutledge St
Fl 2
Springfield, IL 62702
Phone (217) 757-7932

Interoperability endpoints

  • Direct secure messaging: alessandramantovani@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.

Hospital & facility affiliations 5

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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1376944025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST FL 2",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-9752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTOVANI",
        "first_name": "ALESSANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "TRN20344",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "F382",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036.165800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.