Decatur OBGYN Associates, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036072402 Issued in IL

Legal business name

DECATUR OBGYN ASSOCIATES, LLC

Practice address

1 Memorial Dr
Suite 300
Decatur, IL 62526-6303

Phone

(217) 875-5545

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Roy Tsuda, M.D.NPI 1285610519

Title

Vice President

Phone

(217) 875-5545

Specialties & licenses 1

Addresses

Other identifiers 11

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roy Tsuda, MD

  • Obstetrics & Gynecology Physician
  • Decatur, IL
  • NPI 1285610519
  NPD (past) Authorized official
• Gretchen L Byrkit, MD

  • Obstetrics & Gynecology Physician
  • Decatur, IL
  • NPI 1104800044
  NPD
• Jeffrey Pfeiffer, MD

  • Obstetrics & Gynecology Physician
  • Decatur, IL
  • NPI 1134103070
  NPD
• Derin S Rominger, MD

  • Obstetrics & Gynecology Physician
  • Decatur, IL
  • NPI 1821072760
  NPD

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1396897526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266303",
            "telephone_number": "217-875-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266303",
            "telephone_number": "217-875-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR OBGYN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "TSUDA",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "217-875-5545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036072402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086221",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087950",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "020005538",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098445",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104247",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072402",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "160055053",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "1396897526",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "160020964",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "160057787",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CM4913",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Decatur Memorial Hospital
• Decatur Memorial Hospital
• Decatur Memorial Hospital
• Decatur Memorial Hospital
• Decatur Neurological Associates LTD.
• Decatur Open MRI, Inc.
• Decatur Pediatric Clinic
• Decatur Pharmacyxpress LLC
• Decatur Psychiatry LTD
• Decatur Psychological Associates PC

• Obstetrics & Gynecology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.