NPIMap

Individual provider Active NPI

Samuel Anthony Grampsas, MD

  • Urology Physician
  • Springfield, IL
National Provider Identifier
1386618833
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036104697 Issued in IL
Practice address
747 N Rutledge St FL 5
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-7305
NPI assigned
Feb 13, 2006
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036104697 IL Primary

Addresses

Primary practice location

747 N Rutledge St FL 5
Springfield, IL 62702-6700

Mailing address

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

Other practice location 1

1701 E College Ave
Bloomington, IL 61704-2101
Phone (309) 664-3000

Other practice location 2

751 N Rutledge St Lowr Level
Springfield, IL 62702-4968
Phone (217) 545-8000

Other identifiers 4

IdentifierTypeStateIssuer
070519OtherILHEALTH ALLIANCE
036104697MedicaidIL
340019436OtherILRAILROAD MEDICARE
364121826 07OtherILJOHN DEERE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081002000215 IL Practitioner - UrologyPractitioner - Internal Medicine 7911075007 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: Internal Medicine
Education
University of Colorado School of Medicine, Denver, 1995
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)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 1, 2008 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 2, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 2, 2022 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 1, 2008 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
St Marys Hospital Decatur of the Hospital Sisters of the Third Order Past Accepting new patients

Locations

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000

210 W Walnut St
Canton, IL 61520
Phone (309) 647-5240

1001 Main St
Ste 400
Peoria, IL 61606
Phone (309) 308-0920

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

5409 N Knoxville Ave
Ste 102
Peoria, IL 61614
Phone (309) 682-9898

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

747 N Rutledge St
Fl 5
Springfield, IL 62702
Phone (217) 545-3262

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

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

Interoperability endpoints

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

Organizations & group practices 9

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.

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1386618833",
    "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": "844-470-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST FL 5",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 E College Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617042101",
            "country_code": "US",
            "telephone_number": "309-664-3000",
            "fax_number": "309-664-3026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "751 N Rutledge St Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024968",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAMPSAS",
        "first_name": "SAMUEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036104697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "070519",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104697",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340019436",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "364121826   07",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.